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Gastrointestinal Disorders

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Title: Gastrointestinal Disorders


1
Gastrointestinal Disorders
  • BCE 542 (Physical Disabilities, Rehabilitation
    and Employment)
  • September 24, 2002

2
Gastrointestinal System Structure and Function
  • Components
  • Stomach
  • Large and Small Intestines
  • Liver and Gall Bladder
  • (Pancreas)
  • Purpose
  • Digestion--breaking down food into components
    that can be used by the body.

3
Hernias
  • Rips in muscle wall surrounding the digestive
    organs, allowing organs to protrude (herniate)

4
Types of hernias
  • Inguinal--tear in abdominal wall near midline of
    body, usually caused by heavy lifting. More
    common in men.
  • Femoral--follows femoral artery into thigh area.
  • Diaphragmatic--Hernia through diaphragm into
    chest cavity.
  • Hiatal/Hiatus--protrusion of stomach through
    diaphragm opening into the esophagus.
  • Epigastric --Weakness of the upper abdominal
    wall. This type of hernia may be present at
    birth.
  • Incisional--Hernia through improperly healed
    surgical incision.
  • Ventral--Separation of muscles in lower abdominal
    wall, common in pregnancy.

5
Complications, Treatment, and Rehabilitation
  • Strangulation--blood supply cuts off to herniated
    area, eventually leading to gangrene.
  • Treatment
  • Usually surgery, using synthetic mesh to repair
    muscle tears.
  • Some persons may wear trusses (compression
    garments to hold the hernia in place), but this
    is now rare.
  • Rehabilitation
  • Hernias are usually not a rehabilitation concern
    if surgically corrected in some cases, return to
    work in a lighter occupation may be necessary.
  • Prevention is important--teaching of proper body
    mechanics.

6
Stomach and Stomach Disorders
  • The stomach is a muscle lined with a coating of
    mucous in which food is exposed to secretions
    (hydrochloric acid) and turned into a substance
    called chyme.
  • Gastritis--inflammation of the stomach. If
    chronic, can lead to stomach hemorrhage, damage
    to stomach lining.

7
Peptic Ulcers
  • Peptic ulcer--erosion of the mucous lining of the
    stomach, allowing underlying tissue to become
    exposed to gastric acids.
  • Cause is unknown smoking, emotional factors are
    related.
  • Person with ulcer has pain when stomach is empty,
    may be nauseous.
  • Ulcer can perforate, cause ruptures. These are
    medical emergencies.

8
Treatment and Rehabilitation with Peptic Ulcers
  • Treatment
  • Avoidance of certain foods and beverages.
  • Changes in eating patterns, lifestyle.
  • Smoking Cessation
  • Antacids (taken an hour after meals to reduce
    acids)
  • Rehabilitation
  • Persons with peptic ulcers in high-stress
    occupations may require a change in occupation.

9
Intestines
  • Small Intestine--
  • digested food is absorbed into the body.
  • Large intestine
  • absorption of fluids, formation of wastes.

10
Disorders of the Small Intestine
  • Crohns Disease--Chronic inflammations of small
    intestine with abscessing.
  • Cause unknown, appears to be related to certain
    bacteria, autoimmune factors, lifestyle,
    genetics.
  • Treatment is difficult, with bland diet, rest,
    anti-inflammatory drugs.
  • Sometimes surgery is employed to resect (remove
    bypass) affected areas.
  • Rehabilitation concerns involve improving
    adjustment of person to work. There may be no
    specific functional limitations, but reduction of
    emotional issues will assist in healing.

11
Disoders of the Large Intestine
  • Ulcerative colitis--inflammation of the large
    intestine with ulceration.
  • Symptoms include diarrhea with pus and blood,
    anemia, nausea, and dehydration.
  • Cause unknown, but appears related to personality
    factors (rigid, opinionated, emotionally
    immature, compulsively neat)
  • Cancer risk increased.
  • Treatment involves drugs, involvement of
    signficant others, lifestyle changes. Surgery
    may be used to bypass affected area (colostomy)
  • Rehabilitation Individual requires job
    appropriate to personality, needs to feel secure
    and accepted in job. If a colostomy is
    performed, this will add additional
    rehabilitation concerns.

12
Disorders of the Large Intestine, Cont.
  • Diverticulosis--Development of pouches in the
    large intestine.
  • Diverticulitis--Inflammation of these pouches.
  • Incidence increases with age.
  • Can cause abscessing and perforations,
    necessitating surgery.
  • Other treatment involves antibiotics, laxatives,
    diet and lifestyle changes.
  • Rehabilitation
  • May not be a concern if disease is well managed.
  • Reduction of occupational stress is advisable to
    assist in treatment.

13
The Liver and Gallbladder
  • Liver--largest organ in the body performs a
    variety of functions related to metabolism,
    digestion, elimination of body toxins.
  • Gallbladder--An organ adjoining the liver that
    produces bile (important in metabolizing fats.

14
Gallstones and Cholecystitis
  • Gallstones formations of solid structures in the
    gall bladder
  • Many persons show no symptoms, others will have
    nausea, vomiting after eating.
  • Cholecystitis Inflammation of the gall bladder
    caused by gallstones.
  • Can lead to gangrene of gall bladder.
  • Treatment usually calls for surgical removal of
    the gall bladder.
  • Person can live essentially normal life after
    gall bladder removal, but low-fat diet is
    advisable.
  • Rehabilitation considerations usually are not
    relevant.

15
Hepatitis
  • Inflammation of the liver. Three types
  • Infectious Hepatitis (Hepatitis A) Spread by
    germs in unsanitary conditions.
  • Serum Hepatitis (Hepatitis B) Spread by contact
    with body fluids of carrier.
  • Toxic Hepatitis Caused by toxic agents
    (hepatoxins), including alcohol.
  • Symptoms
  • Jaundice (yellowing of the skin)
  • Malaise, loss of appetite, fever, liver
    enlargement
  • Treatment
  • Bed rest, medications, removal of hepatoxins.
  • Hepatitis A usually resolves in a month
    Hepatitis B tends to become chronic.
  • Rehabilitation concerns are only relevant if
    extensive liver damage results.

16
Cirrhosis of the Liver
  • Replacement of liver cells with connective
    tissue/scar tissue.
  • Caused by hepatitis, hepatoxins, untreated
    gallbladder disease, and (especially) extended
    alcohol abuse (Laennecs Cirrhosis).
  • Most common in late middle-aged men.
  • May begin with few or no symptoms.
  • Eventually, person will lose appetite, become
    nauseous.
  • Abdomen will swell with fluid deposits (ascites)
    and limbs will waste away.

17
Cirrhosis (continued)
  • Numerous complications phlebitis, peritonitis,
    internal bleeding, liver infection.
  • Death usually results from massive liver failure
    or from hemorrhage of the esophagus.

18
Cirrhosis, cont.
  • Treatment
  • Cessation of alcohol intake or exposure to other
    hepatoxins.
  • Once damage to liver is done, it is permanent.
  • Rehabilitation
  • Depends on disease progress. If caught early and
    managed, may not be relevant.
  • Alcoholism treatment figures prominently.
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