CHAPTER 8 DIGESTIVE SYSTEM Copyright 2007 by Mosby

Structure and Function The functions of the digestive system are: Breaks down food to a form that can be used by body cells Transports food and waste Physical & chemical breakdown & absorption of digested food Elimination http: //www. youtube. com/watch? v=Rs. Twab. X 4 gg. I on of wastes Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 2

Structure of the Digestive System Mouth Esophagus Stomach Small Intestines Large Intesting Rectum Copyright

Organs of the Digestive Process Mouth Ingestion-putting food into mouth Mastication-the act of chewing Deglutition-the act of swallowing Three glands produce a mix of mucus, water & an enzyme called amylase to activate the taste buds as well as moisten and dissolve CHO’s. Esophagus Carries food from the mouth to the stomach using peristalsis Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 4

Organs of the Digestive Process (Continued) Stomach Chyme- semi liquid undigested food Digestion of protein begins in stomach HCl and pepsin break down proteins Small intestine-most digestion takes place here Produces juices that aid the digestive process Food is actually absorbed here Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 5

Organs of the Digestive Process (Continued) Large intestine Most of the water from ingested food is absorbed back into the blood through the walls of large intestine. Processes fiber Rectum Passes waste out of body Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 6

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Liver Gall bladder Pancreas Small Intestine Function of Accessory Structures - Gallbladder: Secrets bile to break down fat - Pancreas: Releases enzymes to further digest starches, proteins, & fats. Releases insulin to reduce blood sugar levels - Small intestines: Absorbs most nutrients found in your body Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 9

Assessment Techniques Gastric analysis A nasogastric tube is used to remove stomach contents Composition of stomach contents assists in finding: blood, bile, bacteria, cancer, & ulcers. Fecal analysis Examination of stool specimen for presence of microorganisms or blood Performed only be lab personnel Palpation and auscultation Feeling the abdomen and listening for bowel sounds Must gently listen with stethescope first (auscultation), then feel (palpation). Any pushing on the stomach will cause an increase in intestinal activity https: //www. youtube. com/watch? v=XOefpxm 38 bc Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 10

Endoscopy Flexible tube inserted into body cavities www. youtube. com/watch? v=wj. Rsa 77 u

System Lactose Intolerance Not enough of the enzyme lactase is produced. The unabsorbed lactose ferments in the intestines leading to gas, cramps, and diarrhea. Appendicitis Inflammation of the appendix Cholecystitis Inflammation of the gallbladder Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 12

Disorders of the Digestive System Cirrhosis A chronic degenerative condition of the liver accompanied by the formation of scar tissue Constipation The inability to defecate https: //www. youtube. com/watch? v=VM 1 FGtcdx. Do&ebc=ANy. Px. Kpg. Sum. Sw. M 3 t. Opa 8 e. CWk. Ue 0 PEg. Vyz. Cvu-q 5 d. Xkjf 1 D 9 I 0 P 6 U 27 gl. Sh. UYri 48 SQuw. O 2 M 4 RCEv. Nuhqhq 0 y-IPsy. UATCNk. Sw Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 13

Disorders of the Digestive System Crohn’s disease Inflammation and ulceration, usually affecting the ileum and colon, or both Colon cancer An abnormal growth in the large intestine Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 14

OSTOMY BAGS: Allow bowel / bladder to rest https: //www. youtube. com/watch? v=Nps. M 1 b 54 e. To https: //www. youtube. com/watch? v=l 9 PYMfq. NGm 0 https: //www. youtube. com/watch? v=81 Oj 78 esw. OQ Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 15

Disorders of the Digestive System Diarrhea The passage of frequent and watery stools Bland diet suggested B. R. A. T. diet: Bananas, rice, applesauce, toast Diverticulitis The weakening of the colon wall, leading to formation of a pouch, causing infection or abscesses if fecal material trapped Diet: Clear liquids, Low-fiber foods, no residue Food poisoning Illnesses transmitted by food Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 16

Table 16 -2 Bland Diet Copyright © 2007 by Mosby, Inc. , an affiliate

Disorders of the Digestive System Gastritis Inflammation of the stomach lining Halitosis Or bad breath, is caused by anaerobic bacteria Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 18

Disorders of the Digestive System Gastroesophageal reflux disease Frequent heartburn or chest pain, bitter taste in the mouth, difficulty swallowing, frequent hoarseness or coughing http: //video. healthination. com/us news/heartburn-gerd. html Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 19

Disorders of the Digestive System Esophageal Varicies Swollen veins in the walls of the lower part of the esophagus that rupture & begin to bleed Causes: liver failure causes pressure on the esophagus Pancreatitis A mild acute or chronic condition resulting from gallbladder stone blockage, disease, injury, or alcoholism Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 20

Disorders of the Digestive System Heartburn A painful burning sensation in the esophagus caused by the backflow of acidic chyme from the stomach Causes: H. pylori bacteria, alcohol, acidic diet ( especially a combo of caffeine, peppermint, too much food, being overweight, lying down after eating) Hemorrhoid A painful dilated vein in the lower rectum or anus Hepatitis A viral infection of the liver Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 21

Disorders of the Digestive System Pyloric stenosis A birth defect in which a constricted pyloric sphincter does not allow food to pass easily into the small intestine Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 22

Disorders of the Digestive System Ulcer An open sore on the lining of the

Digestive System Issues Foodborne illness Salmonella bacteria Bacteria from contaminated eggs, peanuts, ground meats, fruits, & vegetables Illness typically lasts 4 -7 days Escherichia coli Illness from bacteria found in the envoronment, foods, & the intestines of people & animals Transmitted through contaminated water or food, or contact with sick animals or people Protection: Wash hands after contact w/ animals, cook food well, avoid raw milk & unpasteurized drinks, don’t swallow pool or lake water Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 24

Dysphagia Definition: The act of inhaling fluid or a foreign body in the bronchi and lungs http: //www. youtube. com/watch? v=Mrb. EUDO 6 S 5 U&feature=rela ted http: //www. youtube. com/watch? v=cf. FEw. UFv 0 ys&feature=relate d Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 25

Aspiration Pneumonia http: //www. youtube. com/watch? v=mv. AKyu. I_n. UE Radiography Uses barium to allow structures to show esophagus, stomach, and small intestine http: //www. youtube. com/watch? v=5 Qh. Bv. Xs. J 53 E Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 26

Ways to Prevent Aspiration Patients at risk for aspiration Stroke, Parkinson’s, dementia, patient under anaestetia Indications patient is aspirating Coughing & cyanosis when eating, drinking, or regurgitation of gastric contents Voice change (hoarseness or gurgling) after swallowing Ways to prevent aspiration 30 min. rest before eating (easier time swallowing Sit patient upright in chair or bed (90 degrees) Try the chin-down or chin-tuck maneuver Slow feeding & give smaller bites Alternate solid & liquids Do not let patients drink with a straw Thicken liquids as ordered by speech therapist Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 27

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Digestive System Issues Sulfite-sensitivity May occur naturally or be added to food as an enhancer & preservative 1 in 100 people are sensitive to these compounds Sensitivity to sulfites may occur at any time in life Found in a variety of cooked & processed foods, & occur naturally in beer & wine Reaction occurs w/in minutes , may not be noticed for up to 1 hour Allergies, anaphylaxis, headaches, blurred vision, abdominal cramping, listlessness, rashes Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 29

Issues and Innovations Eating disorders Bulimia: Cycles of binging & purging Anorexia: Severe food restriction **Both are psychological disorders where losing weight becomes a sign of mastery & being “in control” and or having fears of one’s own body. Often accompanied by excessive exercise, overuse of diet pills, diuretics, lacatives, & enemas** Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 30

Issues and Innovations Genetically Engineered Foods, wholly or partially made from genetically modified organism, or GMO. A plant or animal whose genetic material was changed when researchers added a gene from a different plant or animal Over 250 million acres of GMO crops were planted in 2006, over ½ of those in the US Grow & mature faster w/ greater disease resistance & bigger yields No studies exist on their effects on us or the environment Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 31

Issues and Innovations Trans-fats / Hydrogenated Oils First introduced in the 70’s, gained popularity in the 80’s & 90’s when saturated fats were found to be “bad” for your health. Made by injecting hydrogen into lesssaturated oils (liquid at room temp), then making the oil a stable solid at room temperature Your bile cannot break down these oils, releases huge amounts of bile into your system, thus increasing cholesterol levels in the body Copyright © 2007 by Mosby, Inc. , an affiliate of Elsevier Inc. 32