2. The alimentary canal is a long, muscular tube
Structure – it is 25 to 30 feet in length
Includes the mouth, pharynx, esophagus,
stomach, small intestine, large intestine and anus
3. The mouth or buccal cavity chews food called
mastication
Saliva is produced by the parotid, sublingual, and
submadibular glands
Food is broken down by an enzyme called salivary
amylase
The mouth is not a sterile area
4. Food is swallowed in a bolus – and enters the
pharynx
This triggers the epiglottis to close
The bolus continues down the esophagus to the
stomach
Esophagus and stomach are not sterile
5. Once food bolus is in the stomach, the cardiac
sphincter closes to prevent food from flowing back
into the esophagus
Peristalsis(mixing, contracting)begins to
mechanically digest the food, and HCL, pepsin,
lipase are chemically breaking down food
HCL – kills bacteria
Pepsin – breaks down protein
Lipase breaks down fat
6. Food dumps from the stomach to the small
intestine into the duodenum
This section is where bile from the gallbladder and
liver and pancreatic juice enter through the ducts
After this point the small intestine produces
enzymes; maltase, sucrase, and lactase – these
break down sugars into simple forms
Peptidase – for protein
Steapsin – digestion of fat
7. What would happen if we had something wrong
with the pancreas, and we could not produce
enzymes to break food down?
8. This is where nutrients asborb into the blood
stream through the villi of the small intestine
(duodenum, jejunum, ileum)
What remains goes into the large intestine – also
not sterile
This is where water and nutrients like B complex
and Vit K are asborbed
9. If your large intestine became swollen and
irritable, what nutrients could you not absorb, and
how would that effect you?
10. Rectum stores the indigestible food and waste
Waste exits from the anus – also not sterile
11. GERD – Gastroesophageal reflux disease
It is the backwards flow of stomach contents into
the esophagus
Etiology – incompetent(weak) lower esophageal
sphincter makes the stomach contents dump back
into the esophagus
12. Signs and symptoms of GERD
Dyspepsia (heartburn)
Coughing
AM hoarseness
Belching
Chest pain
Regurgitation
Odynophagia – painful swallowing
13. Teach patient
◦ Small meals
◦ Avoid spicy foods
◦ Elevate HOB 8-12”
◦ Sleep in left lateral position
◦ Stop smoking!!!!
14.
15.
16. If you had to explain to a 6 year old how to treat
GERD, how would you do it?
17. Gastritis – inflammation of the gastric mucosa
Two kinds
◦ No. 1 Acute gastritis (erosive) – can be caused by
infection of the helicobacter pylori bacteria. This is
normal to have in your stomach, but if you become
stressed it can have an overgrowth, and cause an ulcer.
It could also be caused by e.coli, or salmonella.
◦ Inflammation can also be “set off” by irritating foods,
chronic aspirin use and alcohol.
18. Signs and symptoms of Acute gastritis:
◦ Rapid onset of epigastric pain
◦ Vomiting blood – can look like coffee grounds
◦ Stomach pain
◦ anorexia
19. Treatment:
◦ EGD (esophagogastroduodenoscopy) is an examination
of the lining of the esophagus, stomach, and upper
duodenum with a small camera (flexible endoscope)
which is inserted down the throat.
◦ Antibiotics to help with h.pylori infection
20. No. 2 Chronic gastritis (non erosive) – constant
irritation without ulcers, develops gradually and is
more likely to cause a dull pain and a feeling of
fullness or loss of appetite after a few bites of
food. For many people, though, chronic gastritis
causes no signs or symptoms at all.
21. Chronic gastritis signs and symptoms – causes
few symptoms:
◦ Vague epigastria pain – usually relieved with food
◦ Intolerance of spicy foods
◦ Anemia – can’t absorb your B12 from food – you need
this for red blood cells to function
22. Diagnosis is same as the Acute – EGD and
antibiotics if needed
23. Treatment for chronic gastritis:
◦ Remove the cause – don’t take too much aspirin, eat too
much acidic/fatty/spicy foods, stop smoking
◦ Medications – antacids, H2 receptor antagonist,
antibiotics, Pepto
24. PUD – Peptic ulcerative Disease – lesions in the
stomach – stress ulcers, h.pylori causes acid
increase
Usually located in the lower stomach, upper
duodenum
25.
26. Complications of PUD:
◦ Bleeding
◦ Melena – blood in the stool is black and tarry, very smelly
◦ Perforation – ulcer wears through the bowel or stomach,
and leaks into the peritoneal cavity – 2-3% of people
perforate, and of this 67% die
◦ 4% have pyloric obstruction – valve is obstructed and
patient has vomiting
27. Test for PUD:
◦ EGD
◦ Blood chemistry (CBC) – checks for anemia
◦ Check of occult blood
◦ Urea breath test – check after midnight if h.pylori is
present patient will have an increase in CO2
◦ Surgery – goes in an stems bleeding
28.
29. IBS – Irritable Bowel Syndrome – 10-20% of U.S.
citizens have this
Chronic recurrent diarrhea, constipation and
bloating, abdominal pain, flares up with certain
foods or stress
30. IBS can flare up with stress or anxiety, food
allergies like lactose intolerance
Can have exacerbation – flare up
Can be in remission – no problems
31.
32. Teach:
◦ Avoid precipitating factors
◦ Patient may need fiber supplements for constipation or
Lomotil for diarrhea
◦ Stress management
◦ May need antidepressants
33. Hemorrhoids – swollen engorged veins in the
anorectic area
Caused by severe straining, childbirth, cancer,
liver disease due to portal hypertension
34. Two types of hemorrhoids
◦ External – swelling of the anus
◦ Internal – inflammation near the anus, and can swell to
the outside – it is possible to have both at the same time
Both cause pain and itching, sometimes bleeding
can occur – will be bright red, unlike melena,
which is black
35. Thrombosed hemorrhoid – Veins in the anus or
outside of the rectum can start to swell and
become external when they protrude outward from
these areas. When blood flow becomes restricted
in these veins, the vessels tend to split causing
pools of blood to form and clot under the skin.
When this happens, you get a thrombosed
hemorrhoid.
36. Treatment of hemorrhoids:
◦ Topical creams – decreases inflammation, eases pain
◦ Diet high in fiber
◦ Avoid – nuts, spices, coffee, alcohol
◦ Avoid sitting for prolonged periods
◦ Avoid valsalva maneuver – no straining, lifting
◦ In case of thrombosed hemorrhoid – surgery is required
to release the blood for the swollen vein – follow with
cold pack
37.
38.
39. Crohn’s disease – is a form of IBS because it
causes inflammation of the lining of the digestive
tract. Crohn’s can extend deep into the layers of
the affected bowel tissue.
40. Common signs and symptoms for Crohns:
◦ Diarrhea
◦ Cramping
◦ Bloody stools
◦ Ulcers – can be severe and perforate through the bowel
◦ Weight loss
41. Other signs and symptoms
People with severe Crohn’s disease may also
experience:
◦ Fever
◦ Fatigue
◦ Arthritis
◦ Eye inflammation
◦ Skin disorders
◦ Inflammation of the liver or bile ducts
◦ Delayed growth or sexual development, in children
◦ See handout
42. Diagnoses with a colonoscopy or barium enema
allows an x-ray of the entire colon
43.
44. Also a form of IBS – Inflammation of the colon
Can be severe and life threatening
Difference in the Crohn’s and ulcerative is right
side Crohn’s left side colitis
Signs and symptoms can range from rectal
bleeding, bloody diarrhea, cramps, pain,
malnutrition, dehydration, shock and even death
45.
46. Treatment for both: Crohn’s and Ulcerative Colitis
◦ Steroids – reduce inflammation
◦ Diet
◦ Stop smoking
◦ No alcohol
◦ For people who do not respond to all of the above, they
might try to suppress the immune system to stop the
body’s allergic response
