THERAPY FOR THE By Toni KasprowiczDIGESTIVE SYSTEM
COLONOSCOPY A colonoscopy is a procedure used to evaluate the colon endoscopically. The colonoscope is four foot long tube and measures four feet in length, is very flexible, and has a camera and light source at the end. The endoscope is inserted slowly into the anus, rectum, and colon as far as the cecum (first part of colon). To prepare for this procedure, the patient must clean out the colon to ensure accuracy. In order to do this, the patient must drink a large amount of cleansing solution or stay on a clear liquid diet with laxatives and enemas several days prior to the procedure.
COLONOSCOPY CONT. During this procedure, the patient is given fluids and sedatives through an IV to make the patient relaxed. The medication also serves to relieve the pressure, bloating, and cramping associated with a colonoscopy. Patients are to lay on their left side while the gastroenterologist advances the scope to the cecum. A suction machine is used to remove feces. The scope is then slowly withdrawn and the doctor will carefully examine the colon’s lining. Usually the doctor will perform a biopsy or remove polyps from the colon. This test is usually performed in about 45 minutes.
COLONOSCOPY CONT. The reasons this procedure is done: bloody stool, abdominal pains and diarrhea Irregularities on x-rays or CT scans Significant change in bowel movements Family history of colon cancer or polyps which could eventually become cancerous Ulcerative colitis Non-colonic cancers To check for tumors, ulcers, polyps, inflammation
HERNIOPLAST Y This procedure is done to repair hernias in the abdominal wall. A hernia is a protrusion of fascia or an organ through the wall of the cavity which contains it. There are dif ferent types of abdominal hernias: Femoral – located in the upper thigh Inguinal – located in the groin Hiatal – located in upper part of stomach, pushing into chest Incisional – occurs through scars from past abdominal surgeries Umbilical – located around belly button when the muscle in the area does not close completely Often there are no symptoms besides discomfort or pain along with a palpable bulge. If a patient is experiencing nausea or vomiting, it is cause for a trip to the emergency room – emergency surgery may be needed.
HERNIOPLAST Y CONT. This surgery is the only way to permanently fix hernias. This procedure uses mesh patches of synthetic material to “plug up” the bulges in the cavity walls. The hernia is pushed back into the cavity in which it belongs, then the patch is sewn over the weakened muscle. This procedure will be done as an emergency surgery if the protruding tissue becomes stuck and the blood supply is pinched of f. If the hernia consists of intestinal tissue, it is important to perform the surgery as soon as possible because that portion of intestine will become strangulated, which results in necrosis.
HERNIOPLAST Y CONT. Hernioplasties are safe and the recurrence rate is low. One of the main risks, in rare cases, is damage to the function of the testicles. Nerve damage is another rare concern. This is usually an outpatient surgery. Recovery time is approximately three weeks, and it is recommended that strenuous activities be avoided for about 5 to 6 weeks after surgery.
GASTRIC LAVAGE This procedure is commonly known as stomach pumping, which is the cleaning of the stomach usually following a patient’s ingestion of poison, drugs, or too much alcohol. It can also be done to investigate levels of bleeding from the upper GI track. It has been used for over 200 years. Once a patient is under complete anesthesia, a nasogastric (NG) tube is inserted through his or her mouth or nose, then passed through down to the stomach. The contents of the stomach are then slowly removed.
GASTRIC LAVAGE CONT. Certain precautions need to be addressed before and during the procedure: The practitioner needs to ensure the tube has reached the stomach instead of the lungs. Placement is confirmed by air insufflation during auscultation of the stomach, or testing a small about of aspirated content for pH level, or through x-ray. Hyponatremia is a concern during this procedure. Warm water pumped into the stomach then removed can disrupt the balance of sodium in the body, causing nausea and vomiting, confusion, headache, and in serious cases, seizures, and coma. Saline can be used to help prevent this condition.
GASTRIC LAVAGE CONT. Besides hyponatremia, there are other complications: Aspiration pneumonia Laryngospasm Hypoxia Bradycardia Epistaxis Hypochloremia This procedure is usually only done when the patient has ingested a life-threatening amount of poison and can be treated with in 60 minutes.
CHOLEDOCHOLITHOTRIPSY This is a common procedure done to destroy gallstones. Gallbladder disease, or cholecystitis, is one of the most common medical disorder which can lead to death if not treated. Gallstones typically form from crystals of cholesterol and become bigger in the gallbladder. As the stones increase in size, they can block the flow of bile emptying in to the intestines. The body will be unable to digest fats without bile. Gallbladder disease causes abdominal tenderness and body soreness with pain radiating to the shoulders. Ultrasound is the primary test used to diagnose gallstones.
CHOLEDOCHOLITHOTRIPSY CONT. It is important to treat gallbladder disease promptly because the gallbladder can perforate or rupture, resulting in peritonitis. Choledocholithotripsy has replaced cholecystectomy as a non-surgical, more advanced alternative. The procedure uses shock waves to shatter gallstones, requires only a local anesthetic, and patients recover quickly. To perform this procedure, the physician will insert a hollow toll called a lithotriptor into the patient’s chest until it nears the stones. Low-current, high-voltage electricity shatters the stones.