Other GI Disorders

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Other GI Disorders

• NPN 200
• Medical Surgical Nursing I

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Diverticulosis / Diverticulitis

• Bulging pouches (diverticuli) found n the GI wall
• Most common site is the sigmoid colon but can
  develop anywhere
• Mickels diverticulum is a congenital disease
  found in the ilium, and is trhe most common GI
  congenital disease
• 2 forms diviterculitis and diverticulosis

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Diverticulosis / Diverticulitis

• Diverticulosis
• Diverticuli present, but no symptoms
• Possibly asymptomatic
• Usually occurs before age 35
• May have change in bowel habits
• Might exhibit bleeding, pain in lower abd, N/V,
  or urinary problems

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Diverticulosis / Diverticulitis

• Diverticulitis
• Diverticular are inflamed and may cause svere
  obstruction, infection, or hemorrhage
• Retained, undigested food mixing with bacteria
  may cause a large mass
• Blood supply is cut off
• Inflammation results
• Condition usually occurs between 50-70 years of
  age, and may result in spasms, obstruction and
  hemorrhage
• Inflamed colon may result in fistula formation to
  the bladder or other organs

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Diverticulosis / Diverticulitis

• Complications
• Bleeding
• Rupture
• Peritonitis
• Fistula formation

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Diverticulosis / Diverticulitis

• Diagnosis
• Based on symptoms
• Occult blood
• ABD CT and barium enema
• Medical treatment
• High residue diet, without spicy foods
• Stool softeners
• Analgesics, no opioids
• Antibiotics
• If acute problems may need NPO, fluids and NG
• Temporary colostomy may be needed to rest bowel
  0r colon resection

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Diverticulosis / Diverticulitis

• Symptoms may have none unless acute
• Recurrent constipation/diarrhea
• Pain
• Bleeding
• Nausea
• Vomiting if obstruction is present
• Low grade fever
• Increased WBC
• If rupture rigid abd, pain, signs of sepsis,
  hemorrhage, absent bowel sounds, N/V

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Diverticulosis / Diverticulitis

• Nursing care
• Dietary management
• Analgesics
• Stool softeners
• Vitals
• Monitor stools
• Antibiotics
• Prepare for surgery

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Anal Fissure and Fistula

• Fissure - a tear between the anus and the
  perianal area
• Related to S/S
• Constipation bleeding, pain
• Diarrhea
• Trauma , childbirth
• Treatment
• Sitz baths
• Stool softeners
• Pain RX

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Anal Fissure and Fistula

• Fistula abnormal opening between anus or bowel,
  which connects to another area.
• Can be between the anal canal and the perianal
  tissue or can occur between the bowel and the
  bladder
• Most serious if the bowel and bladder
• Causes chronic UTI
• If simple, sitz baths and pain RX or may need
  colostomy to relieve problem

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Anorectal Abscess

• Infection of tissue around the anus
• S/S rectal pain, swelling and redness
• Treated with antibiotics
• May require surgery to remove
• Very painful
• Post-op
• Sitz baths
• Pain RX
• Ice packs
• Cleansing after BM

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Cystocele and Rectocele

• Vaginal disorders caused by weakness in the
  vaginal walls between the vagina and the bladder
  or the vagina and the rectum
• Bulging is visible and palpable
• Caused by pregnancy and childbirth
• Large ones may cause difficulty in emptying the
  bowel or bladder
• May also cause leakage , stress incontinence,
  incomplete bladder emptying.
• Can perforate the vaginal wall

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Cystocele and Rectocele

• Treatment
• Small Kegel exercises, estrogen replacement to
  improve tone of vagina
• Large surgery
• A P repair ( anterior and posterior
  colporrhaphy)
• Risk of vaginal stenosis,

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Cystocele and Rectocele

• Nursing care
• Teaching Kegels
• Stool softeners
• Surgical teaching
• Post op care
• Perineal care hot and cold to relieve pain
• Self cath
• Low residue diet
• Avoid sexual intercourse for a time
• May need to use vaginal dilators

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