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Glossary of Digestive Terms

• Absorption: The process where small molecules, vitamins, and minerals pass from the small and large intestines into the bloodstream.
• Amylase: An enzyme that aids in the digestion of starch.
• Anus: The final section of the gastrointestinal (GI) tract, responsible for expelling waste.
• Chyme: The mixture of food, saliva, salivary enzymes, and gastric secretions in the stomach.
• Digestion: The process where digestive enzymes and secretions mix with ingested food to break down proteins, fats, and sugars into smaller molecules.
• Dyspepsia: Also known as indigestion, characterized by upper abdominal discomfort.
• Elimination: The process where waste products are evacuated from the body.
• Ingestion: The phase of digestion when food is taken into the GI tract via the mouth and esophagus.
• Intrinsic Factor: A gastric secretion that assists in the absorption of vitamin B12.
• Lipase: An enzyme that aids in the digestion of fat.
• Microbiome: The collective genome of all microbes in a microbiota.
• Microbiota: The complement of microbes in a given environment.
• Trypsin: An enzyme that aids in the digestion of protein.

Anatomy and Physiology Overview

• The GI tract pathway is approximately 7 to 7.9 kilometers (23-24 feet) long.
• The esophagus is about 25 cm (10 inches) long.
• The diaphragmatic hiatus is the opening in the diaphragm through which the esophagus passes.
• The stomach has a capacity of approximately 1500 ml.
• The small intestine is the longest segment, about 2/3 of the total length.
• The small intestine averages 7 meters in length, absorption primarily occurs here.
• The three sections of the small intestine includes duodenum (proximal), jejunum (middle), and ileum (distal).
• The large intestine consists of the ascending, transverse, and descending sections, ending with the anus, rectum, and sigmoid colon.
• The blood flow to the GI tract is about 20% of the total cardiac output, increasing significantly after eating.

Major Functions of the GI Tract

• Breaking down food particles into molecular forms through digestion.
• Absorption of small nutrient molecules into the bloodstream.
• Elimination of undigested, unabsorbed food and other waste products.

Gastric Function

• Gastric secretions of about 2.4 liters per day come from hydrochloric acid (HCl).
• One function of the gastric function is to break down food into more absorbable components.
• Gastric function aids in the destruction of bacteria.
• Absence of intrinsic factor leads to pernicious anemia.
• Hormones, neuroregulators, and local regulation control the rate of gastric secretions.

Small Intestine Function

• Duodenal secretions come from the pancreas, liver, and gallbladder.
• Pancreatic secretions have an alkaline pH due to a high concentration of bicarbonate.
• Bile, secreted by the liver and stored in the GB, emulsifies ingested fats.
• The sphincter of Oddi controls the flow of bile.
• Intestinal secretions include 1 liter per day of pancreatic juice, 0.5 liters per day of bile, and 3 liters per day from glands of small intestines.
• There are two types of contractions: segmentation contractions and intestinal peristalsis.
• Segmentation contractions produce mixing waves that move intestinal contents back and forth in a churning motion.
• Intestinal peristalsis propels contents through the small intestine.

Colonoscopy Considerations and Oral Cancer

• The primary nursing consideration for a patient undergoing colonoscopy is patient safety.
• There is risk for code, which can lead to muscle relaxants and sedation.
• Early stage of cancer manifests as painless sore or mass that won't heal.

Absorption and Major Enzymes

• Absorption starts in the small intestine, specifically in the jejunum.
• Chewing and swallowing enzymes: saliva, salivary amylase.
• Gastric function enzymes: hydrochloric acid, pepsin, intrinsic factor.
• Small intestine enzymes: amylase, lipase, trypsin, bile.

Assessment of GI System

• Abdominal pain, dyspepsia, gas, nausea, vomiting, diarrhea, constipation, fecal incontinence, jaundice, and previous GI diseases should all be part of the health history assessment.
• Pain assessment should include character, duration, pattern, frequency, location, distribution of referred abdominal pain, and timing.

Symptoms of GI Dysfunction

• Dyspepsia; belching, heartburn, abdominal pain, discomfort, easily feeling full, easily bloated.
• Intestinal gas may include bloating, distention, or feeling "full of gas" with excessive flatulence as a symptom of food intolerance or gallbladder disease.
• Nausea and vomiting can be a vague, uncomfortable sensation of sickness may or may not be followed by vomiting.
• Changes in bowel habits and stool characteristics may signal colonic dysfunction or disease, including constipation and diarrhea.

GI Structural Changes

• Age-related GI changes can be categorized into Structural changes, Esophagus, Stomach and Small Intestine with their subsequent implications
• Injury/loss/decay of teeth, atrophy of taste buds, and reduced saliva production as well as ptyalin and amylase saliva means difficulty chewing and swallowing can occur.
• Decreased motility and emptying, weakened gag reflex, means reflux and heartburn can occur.
• Degeneration and atrophy of gastric mucosal surfaces and decreased secretion of gastric acids, gastric motility with implications may lead to food intolerance or malabsorption.
• Atrophy of muscle and mucosal surfaces with thinning of villi can lead to complaints of indigestion and constipation.
• Decreased mucus secretion leads to mobility transit compliants of indigestion and constipation.

Common GI Symptoms

• Pain; intestinal gas leads to belching or flatulence, nausea and vomiting and dyspepsia, characteristic of Mallory-Weiss tear that is emesis bright red/ coffee grounds.

GI Terms

• Les cortos - disaccharides (sucrose, maltose, galactose)
• mmosaccharides (glucose, fructose); Glucose-major carbs (full)
• proteins - source of energy after Chyme stays in 7-8 hrs.
• vili - fingerlike - produces digestive enzymes and absorbs nutrients
• absorption- major function; begins in duodenum thru active transport & diffusion
• nutrients - absorbed in duodenum jejunum fats, proteins, carbs, Na, Cl and ileum Vit B12, bile, KMG, phosphate

Colon Function

• Gut microbes - major component of colonic contents of large intestine, waste of digestion-75% fluid;25% matter, Gas 150ml
• Elimination of stool begins with distention of rectum
• Gut microbiome protects- pathogens, regulatory influences innate and inflammation

Factors Related to GI

• Injury / loss / decay -loss of teeth
• Atrophy in aging taste buds, saliva output and ptyalin and amylase - causes changes in food digestion
• Reflux heart burn with mobility
• Distension bloating / flatulence expulsion of gas stomach
• Nausea and Vomiting
• Emesis- bright red

Diagnostic Test & Quadrants

• Includes: Serum laboratory studies and Stool tests.
• Includes Anoscopy, proctoscopy, sigmoidoscopy, Small-bowel enteroscopy and Colorectal manometry.
• Abdominal Quadrants 1)Right Upper 2) Right Lower 3) Left Upper 4) Left Lower

Maneuvers for Gi

• Ie: Right Hypochondriac Left Hypochondrine, Right Lumbar Left Lumbar, Right Ingluinal, Left Ingluinal, Unbilical, Epogastic, Suprapubic

Diagnostic Tests & Nursing Intervention

• Include Upper/Lower mobility studies requiring providers to be informed of any known medical conditions prior affecting a procedure

GI's in general

• Important role includes: Pigestinon, saliva
• Alterations causes types and amounts of food eaten and food/food particles mixed and communicated
• Problems causes food and fluid intake affecting general health

Periodical Disease

• Causing toothloss in older/illiterate. Individual that smoke, low income/education that has Rheumatoid and CV, DM

Dental & Plagues

• Plagues causes tooth / decay / treatment and fillings
• Prevent by using: flouride toothpaste to refrain from smoking
• abscesses, medical managements with analgesics

Disorders & Salivary

• Affects function of job temporomandibular that causes tension, click sounds

GI Tract Anatomy

• GI tract consists of: mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus.

GERD

• Common in GERD can have cause of pyloric, stenosis hiatal, hernia, and motility
• Increases with Irritable bowl syndrome and asthma
• Smoking and coffee drinking bad for GERD
• Best way to know is lifestyles
• GERD: can be caused by unmanaged Barrett Esophagus and benign tumors

Esophageal Disease/Health

• Smoking / smoke is risky
• ⅓ will have squamous cell carcinoma
• Diet/lifestyle changes can affect
• Hiatal hernia can affect

Delivering Nutrition

• Safe-cost efective with Preservity, metabolism and Insulin
• Check patient and doctor’ orders
• Tube is inserted thru mouth, washing hands and fluids are entered

Colonstomy Ng Respiratory

• Stop if clumping and give rest period
• Have an open mind towards pt education + diagnosis and lifestyle

Hepatic - 12

• Educates about b12 and b12 rich food
• Cirrhosis alcohol use is caused - check liver and if you have an enema of 4-4 VECO