12.4 – Digestive Diseases, Disorders and Diagnostic Testing
Gastroesophageal Reflux Disease
This condition is largely caused by gastric acid flowing upwards from the stomach into the esophagus. Those suffering from the condition will often feel a burning sensation radiating near the top of the stomach (Mayo Clinic Staff, 2023). To learn more about GERD, visit the Mayo Clinic’s Gastroesophageal Reflux Disease (GERD) page [New Tab].
Cholecystitis
This condition is known as inflammation of the gall bladder. Gallstone development can block the gall bladder’s release of bile leading to an inflammatory response. Surgical removal (cholecystectomy) or laser stone crushing known as lithotripsy are often the treatment options (“Cholecystitis”, 2023). To learn more about cholecystitis, visit the Radiology Info’s cholecystitis web page [New Tab].
Cirrhosis
Cirrhosis is a condition whereby the liver scars. Advanced cirrhosis is life-threatening. It generally can not be reversed. It is caused by different forms of liver disease and chronic alcoholism (Mayo Clinic Staff, 2023).
Cirrhosis often has no signs or symptoms until liver damage is extensive and may include:
- Fatigue
- Easily bleeding or bruising
- Loss of appetite
- Nausea
- Edema
- Weight loss
- Itchy skin
- Jaundice
- Ascitis (Mayo Clinic Staff, 2023).
To learn more about cirrhosis, visit the Mayo Clinic’s Cirrhosis web page [New Tab].
Esophageal Cancer
This is cancer of the esophagus. The cancer can occur anywhere along the esophageal tube, and can be caused by factors including tobacco use, alcohol, and chronic acid reflux (Canadian Digestive Health Foundation, 2020). To learn more about esophageal cancer, visit the CDHF’s Esophageal Cancer web page [New Tab].
Hepatitis A, B and C
Inflammation of the liver is referred to as hepatitis. This condition can be caused by several factors such as viruses, alcohol consumption, toxins, and drug interactions. In some cases it can also be caused by an autoimmune response in the body. There are five types of viral hepatitis: A, B, C, D, and E (Booth, 2018). To learn more, visit Healthline’s article on Hepatitis [New Tab].
Celiac Sprue (Celiac Disease)
Individuals with celiac disease have an immune sensitivity reaction occurring in the small intestines when they consume gluten. Typically, people with this condition are genetically predisposed to the condition. Damage to the small intestine will occur if continued consumption of gluten occurs. Once diagnosed, individuals eat a gluten-free diet as the best approach for the management of the condition (Celiac Disease Foundation, n.d.). To learn more, visit the Celiac Disease Foundation’s What is Celiac Disease? article [New Tab].
Crohn’s Disease and Ulcerative Colitis
Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBD) whereby a section or segments of the digestive tract experience inflammation. Crohn’s disease can occur anywhere along the digestive tract from the mouth to the anus, although it is most often found in the small intestines. This often leads to the malabsorption of nutrients from food. Ulcerative colitis is localized inflammation and ulcers in the colon (Crohn’s and Colitis Canada, n.d.). To learn more, visit Crohn’s and Colitis Canada’s page about Crohn’s and Colitis diseases [New Tab].
Colon Cancer
Colon cancer is a cancer formation in the colon portion of the digestive tract. It is typically found in older adults. Colon cancer is often diagnosed through a colonoscopy (Canadian Digestive Health Foundation, 2020). To learn more, visit the CDHF’s page on colon cancer [New Tab].
Hernia
A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue. A hiatal hernia is found in the upper stomach region.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common disorder affecting the large intestines. IBS often involves abdominal pain as sensitive nerve tissue within the colon reacts to the movement of food and waste through the digestive tract. Along with the abdominal pain individuals often experience gas and bloating. Diet and lifestyle modifications often help in the management of the condition (Canadian Digestive Health Foundation, 2020). To learn more about irritable bowel syndrome, visit the CDHF’s web page on IBS [New Tab].
Polyps
A polyp is a small growth of tissue protruding outward from the intestinal wall. Some cancers in the intestines start off as a polyp. Typically, they are found in people over the age of 50. Polyps start as a small collection of cells found within the colon. Most are harmless but can transition over time into cancerous growth (Mayo Clinic Staff, 2023). To learn more about polyps, review the Mayo Clinic’s patient information page on polyps [New Tab].
Digestive System Medical Terms in Use
Digestive System – Consultation Report
Digestive System – Consultation Report (Text version)
Use the words below to fill in the consultation report:
- diarrhea
- treatment
- electrolytes
- Glucose
- resists walking
- session
- vomiting
- stools
- eyes
- gait
PATIENT NAME: Alex WEBB
AGE: 30
DOB: November 10
SEX: Male
CONSULTANT: Louis D. Wainwright, MD, Gastroenterology
REQUESTING PHYSICIAN: Trevor Sharpe, MD, Family Medicine
REASON FOR CONSULTATION: Please evaluate GI distress.
I was asked to see this 30-year old male in consultation because of unremitting nausea, _______[Blank 1], __________[Blank 2], abdominal pain, dizziness, and low-grade fever. The patient has a poor appetite but reports no weight loss. He has noted some postprandial cramping, midepigastric pain, and unremitting diarrhea but no blood in the _________[Blank 3]. He states he is “healthier,” but he still has some dizziness.
Initial treatment consisted of IV fluids and control of __________[Blank 4]. Thereafter, the patient was progressed to clear fluids and soft diet. He has done well on this routine; however, his dizziness has persisted. Fever has resolved.
On admission, the patient’s lab data revealed CBC with hematocrit of 142, hemoglobin 25 with differential of neutrophils 51%, bands 8%, lymphocytes 26%, monocytes 6%, basophils none. Serum electrolytes were normal. Potassium was low at 3.5, BUN: creatinine ratio was normal. ________[Blank 5] was within normal range. Stool studies were within normal.
On examination, I find the patient to be lethargic and uncomfortable with mild nausea and dizziness. He prefers to keep his eyes closed. On examination of the ________[Blank 6], I find no nystagmus. There is pallor to the skin, and he seems cool to the touch. Upon standing by the bedside, the patient is unsteady. Although he _________[Blank 7], when he attempts to walk, his __________[Blank 8] is halting, and he tends to fall to the left side. Abdomen is flat and nontender. Bowel sounds are WNL. Rectal exam deferred.
RECOMMENDATIONS: I think we should continue essential ________[Blank 9] of this gentleman. Because of the symptoms of dizziness on admission, we may want to consider a CT scan to rule out an intracerebral bleed or subdural hematoma. My opinion at this time is that we are dealing with a resolving __________[Blank 10] of gastritis.
Thank you for asking me to see this patient. I will be glad to follow him with you throughout his hospital stay.
____________________________________
Louis D. Wainwright, MD, Gastroenterology
Check your answers: [1]
Activity source: Digestive System – Consultation Report by Heather Scudder, from Building a Medical Terminology Foundation by Kimberlee Carter and Marie Rutherford, licensed under CC BY- 4.0. / Text version added.
Digestive System – Operative Report
Digestive System – Operative Report (Text version)
Use the words listed below to fill in the operative report:
- esophagitis
- ulceration
- lateral
- stomach
- GE
- sporadic
- retroflexion
- bleeding
- antrum
- duodenum
- lidocaine
- duodenitis
PATIENT NAME: Bruce WEBSTER
AGE: 48
SEX: Male
DOB: September 23
DATE OF ADMISSION: July 2
DATE OF PROCEDURE: July 2
ADMITTING PHYSICIAN: Trevor Sharpe, MD, Family Medicine
SURGEON: Louis D. Wainwright, MD, Gastroenterology
PREOPERATIVE DIAGNOSIS: GI Bleed.
POSTOPERATIVE DIAGNOSES:
- Severe _______[Blank 1].
- Gastroesophageal ________[Blank 2].
- No Significant bleeding seen in the stomach.
OPERATIVE PROCEDURE: Gastrointestinal endoscopy.
ANESTHESIA: _________[Blank 3] 1%.
PROCEDURE: The patient was placed into the left _________[Blank 4] position. A scope was introduced from the mouth, under visualization and advanced to the upper part of the _______[Blank 5], upper part of esophagus, middle of esophagus, ________[Blank 6] junction, and some __________[Blank 7] bleeding was seen at the GE junction. The scope was moved through the upper part of the stomach into the _________[Blank 8]. The __________[Blank 9] showed some inflammation and the scope was then brought out. ________[Blank 10] was not performed. The scope was then brought back slowly. Mild _________[Blank 11] was also seen and a little bit of ulceration noted at GE junction.
CONCLUSION: Severe esophagitis, may be some source of __________[Blank 12] from there, but no active bleeding at this time.
___________________________________
Louis D. Wainwright, MD, Gastroenterology
Check your answers: [2]
Activity source: Digestive System – Operative Report by Heather Scudder, from Building a Medical Terminology Foundation by Kimberlee Carter and Marie Rutherford, licensed under CC BY- 4.0. /Text version added.
Medical Specialties and Procedures Related to the Digestive System
Gastroenterology
This specialty is focused on the diagnosis and treatment of conditions afflicting the digestive system. Gastroenterology is a branch of internal medicine. A physician who specializes in this area is known as a gastroenterologist (Canadian Medical Association, 2019). To learn more about gastroenterology, visit the Canadian Medical Association’s Gastroenterology profile page [PDF].
Procedures
Upper and Lower Gastrointestinal Series
This is a diagnostic procedure involving the introduction of a contrast medium known as barium. Barium can be introduced by ingesting or by enema. After induction of the barium, x-rays can be taken of the upper and lower gastrointestinal system structures (Johns Hopkins Medicine, 2020). To learn more, visit Johns Hopkins Medicine’s web page on barium x-rays [New Tab].
Fecal Occult Blood Test
This is a test for hidden blood in a fecal sample. A patient is provided with a card to place a small segment of fecal output. The sample is viewed under a microscope to look for blood. Blood detection can be an indicator of an abnormal growth occurring in the intestines (Johns Hopkins Medicine, 2020).
Stool Culture
This procedure involves the collection of a small sample of feces which is analyzed for abnormal bacterial growth through a culture check (Johns Hopkins Medicine, 2020).
Esophagogastroduodenoscopy
An EGD (upper endoscopy) is a procedure by which a physician examines the upper gastrointestinal tract (esophagus, stomach, duodenum) using a special instrument called an endoscope. The physician examines the tissues and is able to take a biopsy, if needed (Johns Hopkins Medicine, 2020).
Attribution
Except where otherwise noted, this chapter is adapted from “Digestive System” in Building a Medical Terminology Foundation by Kimberlee Carter and Marie Rutherford, licensed under CC BY 4.0. / A derivative of Betts et al., which can be accessed for free from Anatomy and Physiology (OpenStax). Adaptations: dividing Digestive System chapter content into sub-chapters.