Gastrointestinal ProblemsGastrointestinal Problems
• Indigestion
• Belching
• Diarrhea
• Constipation
• Nausea
• Vomiting
• Anorexia
• Weight gain or loss
• Flatulence
Factors Influencing Gastrointestinal Tract HealthFactors Influencing Gastrointestinal Tract Health
• Poor nutrition
• Medications
• Emotions
• Inactivity
• A variety of other factors
Causes of AnorexiaCauses of Anorexia
• Medication side effects
• Inactivity
• Physical illness
• Age-related changes
• Anxiety and depression
Management of AnorexiaManagement of Anorexia
• Depending on the cause, treatment could consist:
– A high-calorie diet
– Referral to social programs
– Tube feeding
– Hyperalimentation
– Psychiatric therapy
– Medications
Xerostomia (Dry Mouth)Xerostomia (Dry Mouth)
• Causes:
– Drugs
– Sjogren’s syndrome
– Mouth breathing
– Altered cognition
• Interventions:
– Sipping water
– Hard candies
– Saliva substitutes
Factors That Could Lead to Poor Dental Status in EldersFactors That Could Lead to Poor Dental Status in Elders
• Limited funds
• Lack of knowledge
• Diseases
• Fear of Dentists
Causes of DysphagiaCauses of Dysphagia
• Gastroesophageal reflux disease (GERD)
• Stroke
• Structural disorders
Types of DysphagiaTypes of Dysphagia
• Oropharyngeal
– Difficulty transferring food from the mouth into the the pharynx and esophagus.
• Esophageal
– Difficulty transferring food down the esophagus.
Interview Questions for Patients with DysphagiaInterview Questions for Patients with Dysphagia
• When did the problem begin?
• What other symptoms accompany the dysphagia?
• What types of foods are most problematic?
• Is the problem intermittent or present with every meal?
Types of Hiatal HerniasTypes of Hiatal Hernias
• Sliding (axial)
– A part of the stomach and the junction of the stomach and esophagus slide through the diaphragm.
• Rolling (paraesophageal)
– The fundus and greater curvatures of the stomach roll up through the diaphragm.
Symptoms of Hiatal HerniasSymptoms of Hiatal Hernias
• Heartburn
• Dysphagia
• Belching
• Vomiting
• Regurgitation
Symptoms of Esophageal CancerSymptoms of Esophageal Cancer
• Dysphagia
• Weight loss
• Excessive salivation
• Thirst
• Hiccups
• Anemia
• Chronic bleeding
Factors Contributing to Peptic UlcersFactors Contributing to Peptic Ulcers
• Stress
• Diet
• Genetic predisposition
• Longevity
• More precise diagnostic evaluation
• Increasing prevalence of chronic obstructive pulmonary disease
Complications of Peptic UlcersComplications of Peptic Ulcers
• Constipation or diarrhea caused by antacid therapy
• Pyloric obstruction resulting in dehydration, peritonitis, hemorrhage, and shock
Factors Causing Stomach Cancer to Be Common Problem in Late LifeFactors Causing Stomach Cancer to Be Common Problem in Late Life
• Chronic constipation
• Obesity
• Age-related atrophy of intestinal walls
• Low-fiber diet
Factors Contributing to Diverticular DiseaseFactors Contributing to Diverticular Disease
• Chronic constipation
• Obesity
• Hiatal hernia
• Atrophy of the intestinal wall muscles with aging
Medical Management of Diverticular DiseaseMedical Management of Diverticular Disease
• Increase in dietary fiber intake
• Weight reduction
• Avoidance of constipation
Factors Contributing to DiverticulitisFactors Contributing to Diverticulitis
• Overeating
• Straining during a bowel movement
• Alcohol
• Irritating foods
Nursing Interventions for DiverticulitisNursing Interventions for Diverticulitis
• Acute Phase
– Reduce infection.
– Provide nutrition.
– Relieve discomfort.
– Promote rest.
• Following Acute Phase
– Consume a low-residue diet.
Symptoms of Cancer of the ColonSymptoms of Cancer of the Colon
• Bloody stools
• Change in bowel function
• Anorexia
• Nausea
• Epigastric pain
• Jaundice
Screening Measures for Colon CancerScreening Measures for Colon Cancer
• Digital rectal examination
• Fecal occult blood testing
• Barium enema
• Sigmoidoscopy with biopsy
Factors Contributing to Chronic ConstipationFactors Contributing to Chronic Constipation
• An inactive lifestyle
• Low fiber and fluid intake
• Depression
• Laxative abuse
• Certain medications
• Dulled sensations for bowel elimination
• Failure to allow sufficient time for complete emptying of the bowel
Measures to Promote Bowel EliminationMeasures to Promote Bowel Elimination
• Scheduling a regular time for it.
• Incorporating high-fiber foods into the diet.
• Rocking the trunk from side to side and back and forth while sitting on the toilet.
Causes of Bowel ObstructionCauses of Bowel Obstruction
• Cancer of the colon
• Diverticulitis
• Ulcerative colitis
• Hypokalemia
• Vascular problems
• Paralytic ileus
Symptoms of Bowel ObstructionSymptoms of Bowel Obstruction
• Small Bowel Obstruction
– Upper and midabdominal pain in rhythmic recurring waves; vomiting may occur.
• Obstructions Occuring Past the Ileum
– Abdominal distension so severe that the raised diaphragm can inhibit respirations.
– Vomiting is more severe.
Symptoms of Bowel Obstruction (cont.)Symptoms of Bowel Obstruction (cont.)
• Obstruction of the Colon
– Lower abdominal pain, altered bowel habits, distension, and a sensation of the need to defecate. Vomiting usually does not occur until late.
Possible Causes of IncontinencePossible Causes of Incontinence
• Decreased contractile strength
• Impaired automaticity of the puborectal and external anal sphincter
• Reduced reservoir capacity
Symptoms of Pancreatic CancerSymptoms of Pancreatic Cancer
• Anorexia
• Weakness
• Weight loss and wasting
• Dyspepsia
• Belching
• Nausea
• Vomiting
Symptoms of Pancreatic Cancer (cont.)Symptoms of Pancreatic Cancer (cont.)
• Diarrhea
• Constipation
• Obstructive jaundice
• Fever may or may not be present.
• Epigastric pain radiating to the back may be experienced.
Treatment Measures for Biliary Tract DiseaseTreatment Measures for Biliary Tract Disease
• Nonsurgical Therapies
– Rotary lithotrite treatment
– Extracorporeal shock wave lithotripsy
• Standard Surgical Procedures