I would suggest printing this in LANDSCAPE format as the table is too wide to have room to fill out otherwise.

Fill in ALL of the blank cells in the table as you read
Chapter 11, except for the cells with --, which should include the Intervention/Education cell for each condition as well as one other cell for each condition. (For example, the two blank cells for GERD are the (1) treatment and (2) intervention/education sections. Many of this week's SQ will be pulled from your answers from the table as well as the questions below the table.)


Definition
Cause(s)
Symptom(s)/Manifestation(s)
Treatment
Intervention/Education
GERD
(gastroesophageal reflux disease)
reflux of stomach contents into the esophagus, which can cause esophagitis and heart burn
  • Reduced LES pressure contributes
  • hiatal hernia
  • esophagitis/heartburn
  • impairments of gastric emptying
  • esophageal peristalsis




















Gastroparesis
delayed gastric emptying of solids (not liquids)

  • motility disorder (delayed gastric emptying)
(refer to GERD tx)












Achalasia
motor disorder affecting the esophagus, which is a complex neurological condition that causes incomplete relaxation of LES after swallowing
  • neurological condition

  • drugs that relax the LES
  • injection of the LES with botulinum toxin
  • mechanical dilation of the LES
  • esophagomyotomy










Scleroderma



--
  • impairs peristalsis and LES closure
  • (same symptoms as GERD)


--









Gastrectomy
partial or total resection of the stomach
sometimes required for tx of gastric cancer



--















Short Bowel Syndrome

sometimes required in Chron disease, necrotizing enterocolitis, congenital atresias, acute volvulus, strangulated hernias, mesenteric artery occlusion, and similar disorders
  • severely reduces the area available for the absorption of nutrients (3 phases of adaptation)
  • at least 100cm of ileum is required for complete absorption of bile salts (diarrhea)
  • antidiarrheal and anticholingeric drugs (Lomotil)
  • TPN (total parenteral nutrition)
  • small bowel transplantation
  • growth hormone




















Celiac Disease
refer to details for causes and symptoms
genetic disorder that results from an immune reaction to the gliadin portion of gluten (protein found in wheat)
decrease in the length of the villi and in the surface area of the bowel, and the capacity for digesting
disaccharides
(sucrose & lactose) and peptides
  • diarrhea
  • steatorrhea
  • impaired absorption of all nutrients
  • muscle wasting
  • weight loss or failure to gain weight (children)
  • anemia






















Chron Disease
regional ileitis, inflammation though all layers of the bowel wall (most commonly affects terminal ileum)


--

-drug treatment
(such as corticosteroids, antidiarrheals, and antispasmodics)
-possible surgery
















Ulcerative Colitis
congestion, edema and ulcerations in the mucosal and submucosal layers of the bowel (usually involves rectum and colon and sometimes extends to the ileum


--
bloody diarrhea, abdominal and rectal pain, weight loss, and anorexia
refer to tx for Chrons above

Irritable Bowel Syndrome (IBS)
relatively common functional disorder characterized by symptoms related to the colon
unclear
may include allergic/ hypersensitivity reactions, psychosocial factors, or altered GI motility

-keep diary of symptoms to reveal precipitating causes of bouts of IBS
-drug therapy
-psychological support and intervention

















Pancreatitis
inflammation, edema and necrosis of the pancreas as a result of digestion of the pancreas by enzymes normally secreted by the pancreas

-pain in the epigastric region, persistent vomiting, abdominal rigidity, and elevated serum amylase/lipase
-malabsorption and decreased glucose tolerance are common in chronic pancreatitis
- abstinence from alcohol
- analgesics (pain relief)
- pancreatic enzyme replacement therapy
- stone removal or stent placement

























Hepatitis

virus, toxin, obstruction, parasite, or drug (alcohol, chloroform, or carbon tetrachloride)
-jaundice, abdominal pain, hepatomegaly, nausea, vomiting, and anorexia
-elevated serum levels of bilirubin, AST, SGOT, SL, SGPT, LDH common
-remove cause, if known
-antiviral treatment, if applicable










Nonalcoholic Fatty Liver Disease (NAFLD)
increasingly common cause of liver dysfunction
-rule out excessive Etoh (alcohol) intake
-dx with liver biopsy
-higher prevalance among obese individuals
-often associated with metabolic syndrome

-no drug therapy exists
-inconclusive results regarding antioxidant supplements (e.g. vitamin E)
-good control of disorders associated with NASH (e.g. DM, hyperlipidemia)
-med tx insulin resistance

Cirrhosis/Hepatic Encephalopathy
liver dysfunction/severe liver dysfunction often resulting in intolerance to protein

  • portal vein hypertension
  • esophageal and gastric varices
  • GI bleeding
  • hypoalbuminemia
  • ascites
  • jaundice
  • encephalopathy (confusion, increased serum ammonia levels, flapping hand tremor, possible coma)
drug therapy (lactulose)




















Hemochromatosis
excessive iron is stored in various organs, especially in the liver, pancreas, heart, gonads, skin, and joints
genetic disorder
If untreated:
  • disrupts organ function
  • cirrhosis of the liver
  • bronzing of the skin
  • diabetes