Students can learn basic anatomy & physiology about GI System. common diagnostic test related to GI System

1. DISORDERS OF DIGESTIVE
SYSTEM
MS. ZEEL RATHOD
NURSING TUTOR
PP SAVANI SCHOOL OF NURSING
PP SAVANI UNIVERSITY

2. ANATOMY & PHYSIOLOGY OF
GASTRO INTESTINAL SYSTEM

3. ORGANS OF THE DIGESTIVE SYSTEM
Alimentary tract
• Mouth
• Pharynx
• Esophagus
• Stomach
• Small intestine
• Large intestine
• Rectum and anal canal.

4. ORGANS OF THE DIGESTIVE SYSTEM
Accessory organs
• 3 pairs of salivary glands
• pancreas
• liver and the biliary tract.

5. BASIC STRUCTURE OF THE
ALIMENTARY CANAL

6. STOMACH
• It is a J-shaped.
• Four regions:
1. The cardia,
2. The fundus
3. The body
4. The pyloric part
• Sphincter
1. The cardiac sphincter
2. The pyloric sphincter

7. WALLS OF THE STOMACH
1. An outer layer of
longitudinal fibers
2. A middle layer of circular
fibers
3. An inner layer of oblique
fibers.

8. SMALL INTESTINE
• The small intestine comprises three
main sections continuous with each
other.
1. The duodenum
2. The jejunum
3. The ileum

9. LARGE INTESTINE

10. LIVER & PANCREAS

11. COMMON DIAGNOSTIC
PROCEDURE & TESTS

12. ENDOSCOPY
• Gastrointestinal endoscopy involves the direct visual examination of the lumen of the
gastrointestinal tract. It is relatively safe & effective way of evaluating the appearance &
integrity of the gastrointestinal mucosa for the purpose of diagnosis.
• The technique for endoscopic investigations of upper & lower gastrointestinal tract
include…
- Gastroscopy (esophagoduodenogastroscopy)
- ERCP (Endoscopic retrograde cholangiopancreatography)
- EUS (Endoscopic ultrasonography)
- Colonoscopy
- Flexible & rigid sigmoidoscopy

13. • Endoscopy is a nonsurgical procedure used to examine a person's
digestive tract. Using an endoscope, a flexible tube with a light
and camera attached to it, doctor can view pictures of digestive
tract on a color TV monitor.
• During an upper endoscopy, an endoscope is easily passed
through the mouth and throat and into the esophagus, allowing
the doctor to view the esophagus, stomach, and upper part of the
small intestine.
• Similarly, endoscopes can be passed into the large intestine
(colon) through the rectum to examine this area of the intestine.
This procedure is
called sigmoidoscopy or colonoscopy depending on how far up
the colon is examined.

14. • A special form of endoscopy called endoscopic
retrograde cholangiopancreaticography, or ERCP, allows
pictures of the pancreas, gallbladder, and related
structures to be taken. ERCP is also used for stent
placement and biopsies.
• Endoscopic ultrasound or EUS combines upper
endoscopy and ultrasound examination to obtain images
and information about various parts of the digestive tract.

15. INDICATION
• Doctors will often recommend endoscopy to evaluate:
• Stomach pain
• Ulcers, gastritis, or difficulty swallowing
• Digestive tract bleeding
• Changes in bowel habits (chronic constipation or diarrhea)
• Polyps or growths in the colon

16. • In addition, doctor may use an endoscope to take
a biopsy (removal of tissue) to look for the presence of
disease.
• Endoscopy may also be used to treat a digestive tract
problem. For example, the endoscope might not only detect
active bleeding from an ulcer, but devices can be passed
through the endoscope that can stop the bleeding. In the
colon, polyps can be removed through the scope to prevent
the development of colon cancer.
• Also, using ERCP, gallstones that have passed outside the
gallbladder and into the bile duct can often be removed.

17. POTENTIAL COMPLICATIONS
•Perforation (tear in the gut wall)
•Reaction to sedation
•Infection
•Bleeding
•Pancreatitis as a result of ERCP

18. HOW DO I PREPARE FOR ENDOSCOPY?
•Gut Preparation. Examining the upper digestive
tract (upper endoscopy or ERCP) requires nothing
more than fasting for 6-8 hours prior to the
procedure. To examine the colon, it must be
cleared of stool. Therefore, a laxative or group
of laxatives is given on the day before the
procedure.

19. • Sedation. For most examinations with an endoscope, a sedative
is provided. This increases the comfort of the individual
undergoing the examination. The sedative, which is administered
via an injection into the vein, produces relaxation and light sleep.
There are usually few if any recollections of the procedure.
Patients wake up within an hour, but the effects of the medicines
are more prolonged, so it is not safe to drive until the next day.
• General anesthesia is given in only very special circumstances (in
young children, and when very complex procedures are

20. BARIUM SWALLOW& SWALLOW
(UPPER GI SERIECE)
• A barium swallow is a test that may be used to determine
the cause of painful swallowing, difficulty with
swallowing, abdominal pain, bloodstained vomit, or
unexplained weight loss.
• Barium sulfate is a metallic compound that shows up on X-
rays and is used to help see abnormalities in the esophagus
and stomach. When taking the test, Patient need to drink a
preparation containing this solution. Then X-rays track its
path through digestive system.

21. INDICATIONS
• Narrowing or irritation of the esophagus
• Disorders of swallowing (dysphagia - difficulty swallowing), spasms of the
esophagus or pharynx
• Hiatal hernia (an internal defect that causes the stomach to slide partially into the
chest)
• Abnormally enlarged veins in the esophagus (varices) that cause bleeding
• Ulcers
• Tumors
• Polyps (growths that are usually not cancerous, but develop into cancer)
• Gastroesophageal reflux disease (GERD)

22. SIDE EFFECTS
• Allergic reaction or anaphylaxis may occur in people
who are allergic to the barium drink.
• Constipation may develop.
• Accidentally get barium into the trachea (windpipe). The
medical term for this is aspiration.

23. PROCEDURE
• Do not hesitate to discuss with the technicians any questions or
concerns may have before, during, or after the barium swallow
test.
• Patient will drink about 1 and 1/2 cups of a barium preparation-a
chalky drink with the consistency (but not the flavor) of a milk
shake. Children will drink less.
• The barium can be seen on an X-ray as it passes through the
digestive tract.

24. • The barium swallow procedure may take about 30 minutes to finish. In certain cases,
it may take up to 60 minutes to fill the stomach.
• Patient will be strapped securely on back on a table that tilts forward. X-rays to
examine heart, lungs and abdomen will be taken before drink the barium. Then will
be asked to swallow the barium mixture.
• X-rays will be taken again as the barium moves through the digestive system.
Patient will be asked to take more swallows so more pictures can be taken.
• As the barium moves down digestive system, the table will be tilted at various
angles to help spread the barium for different views. Pressure may be applied to
your abdomen to spread the barium. Finally, Patient will be placed horizontally,
asked to take a few more swallows of barium, and X-rayed again.

25. • For a barium swallow, they will take photos of esophagus and upper
stomach, whereas in a barium meal, they will follow the barium that person
have swallowed as it travels through esophagus, stomach, and the upper
portion of your small intestine. This test allows health care professionals to
see the shape of gastrointestinal tract, and to measure whether the digestive
system is moving food through too slowly, too quickly, or just right.

26. • Complications: Constipation following an upper GI series is
common, and could end up with bowel movements that appear
chalky and white for a few days. This is completely normal, but
person can relieve some of the constipation by drinking plenty of
fluids and eating high-fibre foods after the procedure. Although
rare, some individuals can have an allergic reaction to the
mixture.

27. AFTER PROCEDURE
• When Patient return home, normal diet unless advised by doctor.
Because the barium is white, stools will be chalky and light-
colored for 1 to 3 days. Do not be concerned about this.
• Patient should try to drink lots of fluids to help alleviate
the constipation
• Eat food with lots of roughage and fiber such as raw fruits and
raw vegetables.

28. BLOOD TESTS
• Blood tests are frequently used to evaluate various GI disorders
and involve taking a sample of blood. Depending on condition,
the doctor might use blood tests to check:
• Albumin level: Albumin is a protein made by the liver. Below-
normal levels are associated with many chronic liver disorders.
• Bilirubin level: Bilirubin is produced by the liver and is excreted in
the bile. Elevated levels of bilirubin may indicate an obstruction
of bile flow or a defect in the processing of bile by the liver.

29. • Complete blood count: This test examines the different types of cells
in the bloodstream. White blood cells multiply when infection is
present. Red blood cells will be present in smaller amounts than
if patient has lost blood, has an inadequate diet has been inadequate
or has certain diseases.
• Electrolyte level: Electrolytes are minerals, including sodium,
potassium, calcium and glucose. These minerals are important for the
body to function properly. Person who have lost large amounts of
due to vomiting or diarrhea often lose large amounts of the various
electrolytes as well. Physician uses electrolyte tests to help determine
when patient might need extra fluids given intravenously or other
medications to help with dehydration and mineral loss.

30. • Prothrombin time test: This test measures the time it
takes for blood to clot. Blood clotting requires vitamin K
and a protein made by the liver. Liver cell damage and
bile flow obstruction can both interfere with proper
clotting.