Study Guide Chapter 20 Digestion
-Key terms:
oAnorexia: lack of appetite
oCholelithiasis: the formation or presence of gallstones in the
gallbladder
oDiverticulitis: inflammation or infection of the pouches of intestinal
mucosa
oDysphagia: difficulty swallowing
oEdentulous: without teeth
oEsophageal dysphagia: difficulty with the transfer of food down the
esophagus
oFecal incontinence: involuntary passage of stool
oFlatus: gas
oGingivitis: inflammation of the gums surrounding the teeth
oHiatal hernia: portion of stomach protrudes through opening in
diaphragm
oOropharyngeal dysphagia: difficulty transferring food bolus or liquid
from the mouth into the pharynx and esophagus
oPeriodontitis: inflammation of the gums extending to the underlying
tissues, roots of teeth, and bone
oPresbyesophagus: age-related changes to the esophagus causing
reduced strength of esophageal contractions and slower transport of
food down the esophagus
-1: Describe how aging affects gastrointestinal health
oThe tongue atrophies Change is taste buds and taste sensations (may
lead to xerostomia (dry mouth))
oSaliva production decreases and swallowing may be more difficult
oDecreased elasticity of the stomach
oHigher pH in the stomach
oReduced presence of pepsin can interfere with the absorption of protein
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oDecrease in hydrochloric acid can interfere with the absorption of
calcium, iron, folic acid, and vitamin B12
oSlower peristalsis, inactivity, reduced food and fluid intake, drugs, and
a diet low in fiber higher incidence of constipation
oBile salt synthesis decreases
oHepatic blood flow can be reduced as a result of decreased cardiac
output
oPancreas experiences fibrosis, atrophy, and fatty acid deposits
oLiver size decreases with age
oFewer absorbent cells on the surface of the intestinal walls
-2: Discuss measures to promote gastrointestinal health in older adults
oGood fluid intake
oDiet rich in fruits and vegetables
oActivity
oEstablishment of a regular time for bowel elimination
oDietary fiber (20-35 g/day)
-3: List symptoms and management of selected gastrointestinal conditions in
older adults
oDry mouth (xerostomia)
▪
Sip water to relieve dryness, sugarless candy and gum
oDental problems
▪
Regular check ups
▪
Fluoride treatments
▪
Proper dental hygiene
oDysphagia
▪
Difficulties swallowing certain types of food to a complete
inability to swallow
▪
Prevention of aspiration and promotion of adequate nutrition
▪
Eat in an upright position
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oHiatal hernia
▪
Heartburn, dysphagia, belching, vomiting, and regurgitation
▪
Bland diet, small frequent meals, stay upright during and after
meals for about an hour
oEsophageal cancer
▪
Dysphagia, weight loss, excessive salivation, thirst, hiccups,
anemia, and chronic bleeding
▪
Surgical resection, radiation, chemotherapy, laser therapy and
photodynamic therapy
oPeptic ulcer
▪
Pain, bleeding, obstruction, and perforation
▪
Similar treatment to that of younger adults
oCancer of the stomach
▪
Anorexia, epigastric pain, weight loss, and anemia
▪
Symptoms can be insidious and easily mistaken for indigestion
▪
Diet low in red meats and high in antioxidants
▪
Partial or total gastrectomy
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oDiverticular disease
▪
Abrupt onset of pain in LLQ, nausea, vomiting, constipation,
diarrhea, low-grade fever, and blood or mucus in the stool
▪
Reduce infection providing nutrition, relieving discomfort,
promoting rest
▪
Low-residue diet
oColorectal cancer
▪
Bloody stools, change in bowel pattern, anorexia, nausea, pain
over affected region, anemia
▪
Colostomy
oChronic constipation
▪
Inability to have a BM within 3 days
▪
Diet high in fiber and fluid, promotion of regular bowel
elimination, exercise, prunes or chocolate pudding, rocking the
trunk from side to side and back and forth while sitting on the
toilet can stimulate a BM
▪
Laxatives
▪
Dandelion root, cascara sagrada, senna, and rhubarb
oFlatulence
▪
Sitting upright after meals is helpful in allowing gas to rise to the
fundus of the stomach and be expelled
oIntestinal obstruction
▪
Small bowel obstruction: upper and mid-abdominal pain in
rhythmic recurring waves, vomiting
▪
Past the ileum: abdominal distension so severe that the raised
diaphragm
can inhibit respirations, vomiting (more severe and initially is composed of semi-
digested food and later contains bile and is more watery)
▪
Obstruction of the colon: lower abdominal pain, altered bowel
habits, distension, and a sensation of the need to defecate
▪
Bowel obstruction can cause high-pitched peristaltic rushes to be
heard on
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auscultation
▪
Intestinal intubation, surgery
oFecal impaction
▪
Distended rectum, abdominal and rectal discomfort, oozing of
fecal material around the impaction (often mistaken as diarrhea),
palpable, hard fecal mass, fever
▪
Enema (oil retention), manual breaking and removal of feces, 50
mL hydrogen peroxide through a rectal tube
oFecal incontinence
oAcute appendicitis
▪
Severe pain (or minimal and referred), fever may be minimal,
and leukocytosis may be absent
▪
Prompt surgery
oCancer of the pancreas
▪
Anorexia, weakness, weight loss, and wasting, dyspepsia,
belching, nausea, vomiting, diarrhea, constipation, and
obstructive jaundice
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▪
Epigastric pain radiating to the back
▪
Surgery (usually the disease is so advanced by the time
diagnosis is made that the prognosis is usually poor)
oBiliary tract disease
▪
Cholelithiasis
•
Pain
•
Nonsurgical therapies—rotary lithotrite treatment and
extracorporeal shock wave lithotripsy, and standard
surgical procedures
▪
Cancer
•
Pain in the RUQ, anorexia, nausea, vomiting, weight loss,
jaundice, weakness, and constipation
•
surgery, but the prognosis is usually poor
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