ALTERATIONS IN

GIT FUNCTION
PEPTIC ULCER DISEASE

An impairment of the mucosa and deeper

structures of the esophagus, stomach,
duodenum.
The jejunum may also be affected if it
is surgically anastamosed to the stomach
Cause: Helicobacter pylori infection
PEPTIC ULCER DISEASE

Predisposing factors:
1. Stress
2. Cigarette smoking
3. Alcohol
4. caffeine
PEPTIC ULCER DISEASE

Predisposing factors:
5. Drugs
6. Gastritis
7. Zollinger-Ellison Syndrome
8. Irregular hurried meals
PEPTIC ULCER DISEASE

Predisposing factors:
9. Fatty, spicy, highly acidic food
10. Type A personality
11. Type O blood
12. Genetics
PEPTIC ULCER DISEASE

Types of PUD
1. Gastric ulcers
2. Duodenal ulcers
PEPTIC ULCER DISEASE

Hemorrhage is the most life

threatening complication of PUD.
Hemorrhage leads to hypovolemic
shock
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
1. Medications:
a. Antacid
b. Histamine H2 receptor antagonist
Best taken in the morning and bedtime
SE: diarrhea, abdominal cramps, confusion, dizziness,
weakness
Cimetidine and antacid should be administered 1 hour
apart
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
1. Medications:
c. Cytoprotective drug carafate
Administer the medication on an empty
stomach
May cause constipation
If with antacid. Administer 60 mins apart
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
1. Medications:
d. Prostaglandin analogue cytotec
Administered with meals
Causes diarrhea and abdominal pain
Contraindicated to pregnant women
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
1. Medications:
e. Proton pump inhibitors
SE: headache, diarrhea, abdominal pain, nausea
f. Anticholinergics
Atropine sulfate, bentyl, levsin robinul
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
1. Medications:
g. Helicobacter pylori drug treatment
Amoxicillin, Clarithromycin, tetracycline
Advise patient to avoid alcohol
Tetracycline is contraindicated to
pregnant women
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
2. Surgical Interventions
a. Vagotomy
b. Pyloroplasty
c. Antrectomies
d. Subtotal gastrectomy
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
3. Nursing Interventions
a. Relieve pain
b. Encourage patient to promote healthy
lifestyle
The client may eat anything if he is
asymptomatic
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
3. Nursing Interventions
Liberal bland diet
Advise client to eat and chew slowly
Small frequent feedings
Advise to avoid fatty foods, food high in caffeine,
bedtime snacks. Binge eating, large quantities of milk
Encourage patient to quit smoking
Enhance coping through stress therapy
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
3. Nursing Interventions
c. Nursing interventions for client undergoing
gastric surgery
Preop care
Provide psychosocial support
Teach client DBCT
Provide nutritional support
Inform client on postop measures
PEPTIC ULCER DISEASE

COLLABORATIVE MANAGEMENT:
Postop care
Promote patent airway and ventilation
Promote adequate nutrition
Prevent potential complications
DUMPING SYNDROME

is a group of unpleasant vasomotor and GI

symptoms caused by rapid emptying of
gastric content into the jejunum
DUMPING SYNDROME

Signs and symptoms:

Early signs:
Weakness
Tachycardia
Dizziness
Diaphoresis
Pallor
Feeling of fullness or discomfort
Nausea
Abdominal cramps
diarrhea
DUMPING SYNDROME

Signs and symptoms:

Late signs:
Hyperglycemia
DUMPING SYNDROME
Collaborative Management:
1. Advise patient to eat in lying position
2. Place the client in the left side lying position after meal
3. Give patient small frequent feedings
4. Provide high protein diet
5. Limit carbohydrates, no simple sugars
6. Instruct patient to take fluids after meals or in between
meals
7. Advise patient to avoid very hot and cold foods
beverages
GATRIC CANCER

This type of cancer is common among

middle-aged males
GATRIC CANCER

Predisposing factors:
1. Diet high in complex carbohydrates, grains and
salt, smoked fish or meats and low in fresh,
green leafy vegetables and fresh fruits
2. Smoking
3. Alcohol ingestion
4. Use of nitrates; nitrite food preservatives
5. Overheated fat products
GATRIC CANCER

Predisposing factors:
6. Helicobacter pylori infection
7. Chronic atrophic gastritis
8. Pernicious anemia
9. History of gastric ulcers
GATRIC CANCER

Clinical Manifestations
1. Progressive loss of apetite
2. Gastric fullness
3. Dyspepsia or indigestion
4. Hematemesis
5. Melena
6. Weight loss
GATRIC CANCER

Clinical Manifestations
7. Fatigue
8. Pain induced by eating
9. Pain Relieved by vomiting
10. Palpable abdominal mass
GATRIC CANCER

Collaborative Management
1. Surgery Total gastrectomy
2. Chemotherapy
3. Radiation therapy
APPENDICITIS

is the inflammation of the vermiform

appendix
Most common cause is obstruction of the
appendix by fecalith, foreign bodies or
infection
Other causes: low fiber diet, high intake
of refined carbohydrates
APPENDICITIS

Clinical Manifestations:
1. Acute abdominal pain that usually starts
in the epigastric or umbilical region
2. Anorexia, nausea and vomiting
3. Rigid abdomen guarding
4. Rebound tenderness
APPENDICITIS

Clinical Manifestations:
5. Fever and Leukocytosis
6. Psoas sign
7. Decreased or absent bowel sounds
APPENDICITIS

Collaborative Management:
1. Bedrest
2. Maintain NPO
3. Relieve pain
4. Avoid factors that increases peristalsis
5. IV therapy
6. Antibiotic therapy
APPENDICITIS

Collaborative Management:
7. Surgery: appendectomy
if the patient received spinal anaesthesia, position
patient flat on bed after surgery.
Maintain NPO until peristalsis returns
Ambulate patient after 24 hours
If appendicitis ruptured, peritonitis may be
experienced. Penrose drain is inserted, and position
patient in semi fowlers position
Prevent infection from penrose drain
PERITONITIS

Clinical manifestation
1. Abdominal pain and tenderness
2. Abdominal guarding and rigidity
3. Abdominal distention
4. Paralytic ileus
5. Fever
6. Nausea and vomiting
7. Signs of early shock
PERITONITIS

Collaborative Management
1. Monitor VS, I&O
2. NGT insertion
3. Bed rest in semi fowlers position
4. Encourage deep breathing exercises
5. Peritoneal lavage with warm saline to
remove exudates
PERITONITIS

Collaborative Management
6. Insertion of drainage tubes ( penrose
drain, hemovac, Jackson pratt)
7. Fluid, electrolytes and colloid
replacement as ordered
8. Antibiotics as ordered
9. Administration of TPN as ordered