lab13 - 25 The Digestive System Objectives In this chapter...

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149 25 The Digestive System Objectives In this chapter we will study some symptoms of digestive system disorders; diagnostic techniques specific for the digestive system; pancreatitis; the liver disorders hepatitis and cirrhosis; three common inflammatory bowel diseases—ulcerative colitis, Crohn disease, and diverticulitis; appendicitis; and colorectal cancer. Assessment of the Digestive System This chapter discusses the techniques applied in diagnosing digestive system disorders and then goes on to describe some structural and functional diseases involving the digestive system. Disorders related to nutrition and metabolism are discussed in chapter 26. Common Symptoms of Digestive System Disorders Patients with disorders of the digestive system most commonly complain of such symptoms as pain, nausea, dyspepsia (indigestion), anorexia (loss of appetite), and dysphagia (difficulty swallowing). These symptoms can indicate disorders of other body systems as well, so it is necessary to take a careful patient history to determine whether the problem is digestive in nature. Helpful questions include, “When did you first notice the pain?” “Where do you feel the pain?” and “What makes the pain better (or worse)?” For example, a patient complaining of dyspepsia localized to the epigastric region and alleviated by eating may have an ulcer, while a patient experiencing abdominal pain in the right lower quadrant that is not alleviated by eating may have appendicitis. Physical Examination Examination of the digestive system involves observation, palpation, percussion, and auscultation. For example, if a patient complains of anorexia and dysphagia, the clinician may look into the oral cavity for lesions or bleeding gums. If the clinician notes jaundice (yellowish skin, corneas, mucous membranes, and body fluids), he or she may have uncovered a clue to liver disease or gallbladder obstruction. A distended abdomen could indicate anything from obesity or pregnancy to ascites or cancer. Striae (stretch marks) may suggest edema, Cushing disease, or ascites. Palpating the abdomen enables the clinician to evaluate the size, shape, and texture of an organ. Intestinal peristalsis can be felt in nonobese patients, and abnormal peristaltic waves can indicate certain diseases. In many liver diseases, the liver becomes larger and firmer than normal. Palpation also allows the clinician to determine whether the abdominal muscles are excessively contracted or relaxed. In some diseases, a patient experiencing abdominal pain may contract the abdominal muscles to “protect” the region; this is known as abdominal guarding . In addition, some patients present with rebound tenderness whereby they do not experience excessive pain upon palpation but report sudden pain when the examiner’s fingers are removed. Using palpation, the clinician may also be able to pinpoint the specific areas that are painful to help determine precisely which organ is involved as well as to check for
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lab13 - 25 The Digestive System Objectives In this chapter...

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