Chapter 23
The Digestive System
905
trauma or rupture (from vomiting), and severe electrolyte
disturbances which impair heart activity. Terapy includes
hospitalization to control behavior, and nutritional counseling.
Dysphagia
(dis-fa
9
je-ah;
dys
5
difficult, abnormal;
phag
5
eat)
Difficulty swallowing; usually due to obstruction or physical
trauma to the esophagus.
Endoscopy
(en-dos
9
ko-pe;
endo
5
within, inside;
scopy
5
viewing)
Visual examination of a ventral body cavity or the interior
of a visceral organ with a flexible tubelike device called an
endoscope, which contains a light source and a lens. A general
term for a colonoscopy (viewing the colon), sigmoidoscopy
(viewing the sigmoid colon), etc.
Enteritis
(
enteron
5
intestine) Inflammation of the intestine,
especially the small intestine.
Hemochromatosis
(he
0
mo-kro
0
mah-to
9
sis;
hemo
5
blood;
chroma
5
color; osis
5
condition of) A disorder in iron metabolism due to
excessive/prolonged iron intake or a breakdown of the mucosal
iron barrier; excess iron is deposited in the tissues, increasing skin
pigmentation and the risk of hepatic cancer and liver cirrhosis.
Also called
bronze diabetes
and
iron storage disease
.
Ileus
(il
9
e-us) A condition in which all GI tract movement stops and the
gut appears to be paralyzed. Can result from electrolyte imbalances
and blockade of parasympathetic impulses by drugs (such as those
commonly used during abdominal surgery); usually reversed when
these interferences end. Te reappearance of intestinal sounds
(gurgling, etc.) indicates restoration of motility.
Inflammatory bowel disease (IBD)
A noncontagious, periodic
inflammation of the intestinal wall now understood to be an
abnormal immune and inflammatory response to bacterial
antigens that normally occur in the intestine. Linked to a newly
discovered ±
H
cell (±
H
17), certain cytokines, and a deficit of
antimicrobial substances normally secreted by the gut mucosa
(lysozyme, defensins, and others). Afflicts up to two of every 1000
people. Symptoms include cramping, diarrhea, weight loss, and
intestinal bleeding. ±wo subtypes occur: (1) Crohn’s disease, a
syndrome characterized by relapsing and remitting periods, is more
serious, with deep ulcers and fissures developing along the whole
intestine, but mostly in the terminal ileum. (2) Ulcerative colitis
Remember Mr. Gutteman, the
gentleman who was dehydrating? It
seems that his tremendous output
of urine was only one of his current
problems. Today, he complains of a headache, gnawing epigastric
pain, and “the runs” (diarrhea). To pinpoint the problem, he is
asked the following questions.
Have you had these symptoms previously? (Response: “Yes, but
never this bad.”)
Are you allergic to any foods? (Response: “Shellfish doesn’t like
me and milk gives me the runs.”)
As a result of his responses, a lactose-free diet is ordered for Mr.
Gutteman instead of the regular diet originally prescribed.
1.
Why is the new diet prescribed? (What is believed to be his
problem?)
Mr. Gutteman’s problem continues despite the diet change.
In fact, the frequency of diarrhea increases and by the end of the
next day, he is complaining of severe abdominal pain. Again, he is
asked some questions to probe his condition. One is whether he
has traveled outside the country recently. He has not, reducing the
possibility of infection with
Shigella
bacteria, which is associated
with poor sanitation. Other questions:
Do you drink alcohol and how much? (Response: “Little or none.”)
Have you recently eaten raw eggs or a salad containing
mayonnaise at a gathering? (Response: “No.”)
Are there certain foods that seem to precipitate these attacks?
(Response: “Yes, when I have coffee and a sandwich.”)
2.
On the basis of these responses, what do you think Mr. Gutteman’s
diarrhea stems from? How will it be diagnosed and treated?
(Answers in Appendix H)
Case Study
Digestive System
is characterized by a shallow inflammation of the large-intestinal
mucosa, mainly in the rectum. Both types are treated with a special
diet, reducing stress, antibiotics, and anti-inflammatory and
immunosuppressant drugs. Extremely severe cases of ulcerative
colitis are treated by colectomy (removal of a portion of the colon).
Laparoscopy
(lap
0
ah-ros
9
ko-pe;
lapar
5
the flank;
scopy
5
observation) Examination of the peritoneal cavity and its organs
with an endoscope inserted through the anterior abdominal
wall. OFen used to assess the condition of the digestive organs
and the pelvic reproductive organs of females.
Orthodontics
(or
0
tho-don
9
tiks;
ortho
5
straight) Branch of dentistry
that prevents and corrects misaligned teeth.
Pancreatitis
(pan
0
kre-ah-ti
9
tis) A rare but extremely serious
inflammation of the pancreas. May result from excessively high
levels of fat in the blood or excessive alcohol ingestion, but
most oFen results when a gallstone blocks the bile duct and
pancreatic enzymes are activated in the pancreatic duct, causing
the pancreatic tissue and duct to be digested (literally, eating
from within). Tis painful condition can lead to nutritional
deficiencies because pancreatic enzymes are essential to food
digestion in the small intestine.
Peptic ulcers
±erm referring to gastric and duodenal ulcers.
Proctology
(prok-tol
9
o-je;
procto
5
rectum, anus;
logy
5
study of)
Branch of medicine dealing with treatment of diseases of the
colon, rectum, and anus.
Pyloric stenosis
(pi-lor
9
ik stĕ-no
9
sis;
stenosis
5
narrowing,
constriction) Congenital abnormality in which the pyloric
sphincter is abnormally constricted. Tere is usually no problem
until the baby begins to take solid food, and then projectile
vomiting begins. Corrected surgically.
Vagotomy
(va-got
9
o-me) Cutting or severing of the vagus nerve to
decrease secretion of gastric juice in those with peptic ulcers that
do not respond to medication.
Xerostomia
(ze
0
ro-sto
9
me-ah;
zer
5
dry,
stom
5
mouth) Extreme
dryness of the mouth; can be caused by cysts that block salivary
glands or autoimmune invasion of the salivary glands or ducts
(Sjögren’s syndrome).
23
Related Clinical Terms
(continued)
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