DOCSLIB.ORG

Gastroenterologydistribution NOT for SALE OR DISTRIBUTION

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Gastroenterologydistribution NOT for SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION SECTION V © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR GastroenterologyDISTRIBUTION NOT FOR SALE OR DISTRIBUTION Constipation 1,2,3,4 © Jones & Bartlett Learning, LLC Definition © Jones & Bartlett Learning, LLC Constipation is a disturbance in bowel function, characterized by NOT FOR SALE OR DISTRIBUTIONinfrequent or difficult defecation.NOT FOR SALE OR DISTRIBUTION Causes 1 ,2,3,5,6,7 • Functional disorders • Normal colonic transit, slow transit constipation, © Jones & Bartlettdyssynergic Learning,defecation (e.g., LLC anismus or pelvic fl oor © Jones & Bartlett Learning, LLC NOT FOR SALEdysfunction) OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Medications • Opioids, anticholinergics, calcium channel blockers, iron supplementation, antacids • Neurological disorders © Jones & Bartlett Learning,• Parkinson’s LLC disease, multiple sclerosis, spinal© Jones cord injury, & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONdementia NOT FOR SALE OR DISTRIBUTION • Metabolic disorders • Hypothyroid, diabetes, hypercalcemia • Blockages of the colon • Colon cancer, stricture or narrowing • Mood-related disorders © Jones & Bartlett Learning, LLC • Depression, anxiety © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Risk Factors 1 ,2,3,6,7 Risk factors of constipation coincide with causes, • Advanced age • Female sex © Jones &• Bartlett More than twiceLearning, as common LLC than men © Jones & Bartlett Learning, LLC NOT FOR• ReducedSALE mobilityOR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Low-fluid intake © tofutyklein/Shutterstock 145 © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284153828_CH05.indd 145 11/6/18 12:55 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Gastroenterology © Jones & Bartlett Learning,• Low-fiber LLCdiet © Jones & Bartlett Learning, LLC • Low socioeconomic status NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Signs & Symptoms1,2,3,4,6 • Have ≤ three stools/week. • Rectal fullness or feeling of inadequate bowel emptying. • Straining with defecation. © Jones & Bartlett Learning, LLC • Hard or lumpy stools. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONTests1,2,3,4,6,7 NOT FOR SALE OR DISTRIBUTION Tests are warranted if constipation has no clear etiology. • Complete blood count (CBC) • The presence of anemia suggests a secondary cause and © Jones & Bartlettshould be investigated. Learning, LLC © Jones & Bartlett Learning, LLC • Thyroid-stimulating hormone (TSH) NOT FOR •SALE Checks ORfor the DISTRIBUTION presence of hypothyroidism (secondary NOT FOR SALE OR DISTRIBUTION cause of constipation). • Basic metabolic panel (BMP), magnesium, and fasting glucose • Checks for electrolyte imbalance (hypercalcemia, low magnesium, and/or potassium) and hyperglycemia, which © Jones & Bartlett Learning,are secondary LLC causes of constipation. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION• Plain abdominal radiography NOT FOR SALE OR DISTRIBUTION • Checks for significant stool retention. • Colonoscopy • Recommended if warning signs are present (e.g., anemia, unexplained weight loss, positive fecal occult blood, gas- trointestinal [GI] bleeding, or constipation refractory to © Jones & Bartlett Learning, LLC treatment). © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Treatment & Management1,2,3,4,6,7 • Nonpharmacological and nursing interventions: • Identify and treat potentially reversible causes of constipation. © Jones & Bartlett• Increase dietaryLearning, fiber to LLC25–35 g per day. © Jones & Bartlett Learning, LLC • Encourage adequate fluid intake (goal of 1.5–2 L/day). NOT FOR SALE• Increase OR physical DISTRIBUTION activity. NOT FOR SALE OR DISTRIBUTION 146 © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284153828_CH05.indd 146 11/6/18 12:55 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Gastroenterology © Jones & Bartlett Learning,• Monitor LLC for warning signs of possible malignancy.© Jones & Bartlett Learning, LLC • Constipation presenting acutely, anemia, abdominal NOT FOR SALE OR DISTRIBUTIONpain, unintentional weight loss, rectal bleeding,NOT FOR or a SALE OR DISTRIBUTION family history of colorectal cancer. • Schedule bathroom time. • Make time to have a bowel movement and ensure privacy. • Remind patients that the best potential for a bowel © Jones & Bartlett Learning, LLC movement is in the© morning Jones and &about Bartlett 45 minutes Learning, fol- LLC NOT FOR SALE OR DISTRIBUTION lowing a meal. NOT FOR SALE OR DISTRIBUTION • Do not postpone having a bowel movement if there is an urge to defecate. • Educate patients on constipation. • If there are minimal to no constipation symptoms, in- © Jones & Bartlettstruct patient Learning, to stop taking LLC laxatives. © Jones & Bartlett Learning, LLC • Being obsessed over bowel movements is not good; NOT FOR SALEhaving OR a daily DISTRIBUTION bowel movement is not necessary. NOT FOR SALE OR DISTRIBUTION • Patients need to engage in exercise and increase their fiber intake. • Biofeedback • Effective treatment for dyssynergic defecation. © Jones & Bartlett Learning,• Pharmacological LLC and other interventions:© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONConsider discontinuing medications that NOThave a sideFOR effect SALE OR DISTRIBUTION of constipation (if appropriate). • Bulking agents (e.g., psyllium [Metamucil]). • Example: psyllium 1 tsp (3.4 g) QD-TID with fluids PRN. • Promotes softer stool by increasing the bulk of the stool. © Jones & Bartlett Learning, LLC Will need to drink plenty© Jones of water & for Bartlett a better outcome. Learning, LLC NOT FOR SALE OR DISTRIBUTION • Not recommended NOTas first-line FOR agent SALE in patients OR onDISTRIBUTION high-dose opioids or with dysphagia. • May cause bloating or flatulence. • Stool softeners (e.g., docusate sodium [Colace]). • Example: Colace 100 mg PO BID. © Jones & Bartlett• Not to be Learning, used as chronic LLC treatment or in patients tak- © Jones & Bartlett Learning, LLC ing opioids. NOT FOR SALE• Well toleratedOR DISTRIBUTION and can be combined with a bulking agent. NOT FOR SALE OR DISTRIBUTION 147 © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284153828_CH05.indd 147 11/6/18 12:55 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Gastroenterology © Jones & Bartlett Learning,• Osmotic LLC agents (e.g., lactulose [Kristalose],© polyethyleneJones & Bartlett Learning, LLC glycol [Miralax], magnesium citrate) NOT FOR SALE OR DISTRIBUTION• Example: lactulose 15–30 mL PO QD-BID.NOT FOR SALE OR DISTRIBUTION • Lactulose recommended in those residing in nursing homes. • Consider when bulking agents and stool softeners are ineffective. © Jones & Bartlett Learning, LLC • May cause bloating© and/or Jones flatulence. & Bartlett Magnesium Learning, ci- LLC NOT FOR SALE OR DISTRIBUTION trate should be avoidedNOT with FOR renal impairment.SALE OR DISTRIBUTION • Stimulants (e.g., senna [Peri-Colace, Senokot], or bisaco- dyl [Dulcolax]) • Example: bisacodyl 5–15mg PO QD. • Should be used short term and avoided with bowel ob- © Jones & Bartlettstruction. Learning, Used when osmotic LLC agents are ineffective. © Jones & Bartlett Learning, LLC • Increases peristaltic contractions and can have unfa- NOT FOR SALEvorable OR side DISTRIBUTION effects such as abdominal cramping. NOT FOR SALE OR DISTRIBUTION • Secretagogues (i.e., lubiprostone [Amitiza] and lina- clotide [Linzess]) • Example: lubiprostone 24 mcg PO BID. • Recommended as monotherapy and not with other © Jones & Bartlett Learning,laxatives. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION• They are usually well-tolerated; howeverNOT may causeFOR GI SALE OR DISTRIBUTION disturbances (e.g., nausea, abdominal distention). Di- arrhea is the main side effect of linaclotide. • Alvimopan (Entereg) or methylnaltrexone (Relistor) • Treats opioid-induced
Load more

Recommended publications
  • Dysphagia Symptoms in People with Diabetes
    DYSPHAGIA SYMPTOMS IN PEOPLE WITH DIABETES: A PRELIMINARY REPORT MCKENZIE G. WITZKE Bachelor of Arts in Biology and Psychology The College of Wooster May 2015 submitted in partial fulfillment of requirements for the degree MASTER OF ARTS at the CLEVELAND STATE UNIVERSITY MAY 2020 We hereby approve this thesis For MCKENZIE G. WITZKE Candidate for the Master of Arts degree for the Department of Speech Pathology and Audiology And CLEVELAND STATE UNIVERSITY’S College of Graduate Studies by _______________________________________ Violet Cox Chair, Thesis Committee Department of Speech Pathology and Audiology ________________________________________ Myrita Wilhite Committee member Department of Speech Pathology and Audiology ________________________________________ Anne Su Committee member Department of Health Sciences ___________________April ______________________29, 2020 Date of Defense ACKNOWLEDGEMENTS I wish to express my sincere appreciation to my advisor, Dr. Violet Cox, who has expertly guided me through this process and showed me nothing but patience and support as I navigated this new experience. I would also like to thank Dr. Myrita Wilhite for her encouragement and willingness to provide resources to help me complete this project. Last but not least, I would like to acknowledge the support of my friends and family, who provided consistent camaraderie and encouragement. DYSPHAGIA SYMPTOMS IN PEOPLE WITH DIABETES: A PRELIMINARY REPORT MCKENZIE G. WITZKE ABSTRACT BACKGROUND: Diabetes mellitus is a systemic disease affecting whole-body functioning. The underlying mechanisms and associated concomitant conditions suggest an increased risk for the occurrence of oropharyngeal dysphagia. PURPOSE: This is a qualitative study designed to assess perception of symptoms of oropharyngeal dysphagia in people with diabetes. METHODS: Participants were recruited by word-of-mouth and asked to complete a survey by answering questions on a Likert-type scale indicating the frequency with which they experience each symptom.
    [Show full text]
  • Dysphagia - Pathophysiology of Swallowing Dysfunction, Symptoms, Diagnosis and Treatment
    ISSN: 2572-4193 Philipsen. J Otolaryngol Rhinol 2019, 5:063 DOI: 10.23937/2572-4193.1510063 Volume 5 | Issue 3 Journal of Open Access Otolaryngology and Rhinology REVIEW ARTICLE Dysphagia - Pathophysiology of Swallowing Dysfunction, Symptoms, Diagnosis and Treatment * Bahareh Bakhshaie Philipsen Check for updates Department of Otorhinolaryngology-Head and Neck Surgery, Odense University Hospital, Denmark *Corresponding author: Dr. Bahareh Bakhshaie Philipsen, Department of Otorhinolaryngology-Head and Neck Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark, Tel: +45 31329298, Fax: +45 66192615 the vocal folds adduct to prevent aspiration. The esoph- Abstract ageal phase is completely involuntary and consists of Difficulty swallowing is called dysphagia. There is a wide peristaltic waves [2]. range of potential causes of dysphagia. Because there are many reasons why dysphagia can occur, treatment Dysphagia is classified into the following major depends on the underlying cause. Thorough examination types: is important, and implementation of a treatment strategy should be based on evaluation by a multidisciplinary team. 1. Oropharyngeal dysphagia In this article, we will describe the mechanism of swallowing, the pathophysiology of swallowing dysfunction and different 2. Esophageal dysphagia causes of dysphagia, along with signs and symptoms asso- 3. Complex neuromuscular disorders ciated with dysphagia, diagnosis, and potential treatments. 4. Functional dysphagia Keywords Pathophysiology Dysphagia, Deglutition, Deglutition disorders, FEES, Video- fluoroscopy Swallowing is a complex process and many distur- bances in oropharyngeal and esophageal physiology including neurologic deficits, obstruction, fibrosis, struc- Introduction tural damage or congenital and developmental condi- Dysphagia is derived from the Greek phagein, means tions can result in dysphagia. Breathing difficulties can “to eat” [1].
    [Show full text]
  • XEROSTOMIA (Dry Mouth)
    XEROSTOMIA (Dry Mouth) What is xerostomia? Are you constantly thirsty? Do you have difficulty swallowing certain foods? Is your saliva thick, foamy, or dry? If you answered “yes” to any of these questions, you may have xerostomia. Xerostomia is a condi- tion characterized by a decrease in saliva production. This happens when the salivary glands stop working or do not function properly, leaving the mouth dry and uncomfortable. Why is xerostomia a problem? Saliva is important because it helps with the digestion process, prevents tooth decay and gingivitis, and protects and lubricates the tongue and other delicate tissues inside the mouth. Saliva also plays an impor- tant role in helping us taste the foods we eat. Dry mouth sufferers are more likely to develop tooth decay, fungal infection of the mouth, denture sores, gum disease, bad breath, and general irritation and discomfort of the oral tissues. What causes dry mouth? Prescription and over-the-counter medications are the most common cause of dry mouth, contributing to more than 80% of all cases. There are, however, many more factors that can play a role in this condition. Let’s explore all potential factors below: Medications – there are over 350 medications that can contribute to dry mouth • Antiseizure (epilepsy) or Antiparkinsonian • Diuretics (blood pressure): Dyazide, Lasix •Antihypertensives (blood pressure): Atenolol, Tenormin, Inderal • Bronchodilators: Albuterol, Proventil, Ventolin, Beclovent, Vanceril, Pulmicort • Sedatives and tranquilizers • Antidepressants/antianxiety:
    [Show full text]
  • PE3334 Difficulty Swallowing (Dysphagia)
    Difficulty Swallowing (Dysphagia) This handout talks about problems your child has in the throat (pharynx) when they swallow, how we diagnose it and how we treat it. What is dysphagia? Dysphagia means difficulty swallowing. Food and drink can get stuck (dis-FAY-je-ya) in the esophagus or “go down the wrong pipe” to the lungs (called aspiration) instead of the stomach. It can also go into the voice box but not all the way into the lungs (called penetration). Epiglottis up for breathing Mouth Throat Liquid in throat (oral (pharyngeal cavity) space) Epiglottis down for eating and drinking Windpipe Liquid in Swallowing tube (Airway or airway (Esophagus) Trachea) Where does dysphagia Difficulty swallowing can happen in 3 places: in the mouth (oral happen? dysphagia), in the throat (pharyngeal dysphagia), and in the swallowing tube (esophageal dysphagia). This handout focuses on pharyngeal dysphagia. Why is pharyngeal When swallowing doesn’t happen the right way in the throat, it can dysphagia a problem? lead to liquid or food getting into the lungs (penetration and aspiration). What are the Food and drink going down the windpipe can damage the lungs. consequences of Some examples of damage are: getting liquid or food • Frequent or long-lasting colds or lung infections into the lungs • Frequent wheezing, coughing, or asthma symptoms (aspiration)? • Difficulty with feeding and growth • In the long-term, this can result in permanent damage to the lungs 1 of 3 To Learn More Free Interpreter Services • Otolaryngology • In the hospital, ask your nurse. 206-987-2105 • From outside the hospital, call the • Ask your child’s healthcare provider toll-free Family Interpreting Line, 1-866-583-1527.
    [Show full text]
  • The Gastrointestinal System and the Elderly
    2 The Gastrointestinal System and the Elderly Thomas W. Sheehy 2.1. Introduction Gastrointestinal diseases increase with age, and their clinical presenta­ tions are often confused by functional complaints and by pathophysio­ logic changes affecting the individual organs and the nervous system of the gastrointestinal tract. Hence, the statement that diseases of the aged are characterized by chronicity, duplicity, and multiplicity is most appro­ priate in regard to the gastrointestinal tract. Functional bowel distress represents the most common gastrointestinal disorder in the elderly. Indeed, over one-half of all their gastrointestinal complaints are of a functional nature. In view of the many stressful situations confronting elderly patients, such as loss of loved ones, the fears of helplessness, insolvency, ill health, and retirement, it is a marvel that more do not have functional complaints, become depressed, or overcompensate with alcohol. These, of course, make the diagnosis of organic complaints all the more difficult in the geriatric patient. In this chapter, we shall deal primarily with organic diseases afflicting the gastrointestinal tract of the elderly. To do otherwise would require the creation of a sizable textbook. THOMAS W. SHEEHY • Birmingham Veterans Administration Medical Center; and University of Alabama in Birmingham, School of Medicine, Birmingham, Alabama 35233. 63 S. R. Gambert (ed.), Contemporary Geriatric Medicine © Plenum Publishing Corporation 1988 64 THOMAS W. SHEEHY 2.1.1. Pathophysiologic Changes Age leads to general and specific changes in all the organs of the gastrointestinal tract'! Invariably, the teeth show evidence of wear, dis­ cloration, plaque, and caries. After age 70 years the majority of the elderly are edentulous, and this may lead to nutritional problems.
    [Show full text]
  • Xerostomia and Hyposalivation (“Dry Mouth”)
    Division of Oral Medicine and Dentistry Xerostomia and Hyposalivation (“Dry Mouth”) What is xerostomia and hyposalivation? What causes hyposalivation? Xerostomia is the sensation of having a dry mouth. Many Te three most common causes of hyposalivation are (but not all) patients who have this sensation will also have a medications, chronic anxiety or depression, and dehydration. noticeable and measurable decrease in the amount of saliva Some medications that cause dry mouth are treatments for in their mouths, a condition referred to as “hyposalivation” sinusitis, high blood pressure (such as “water pills”), anxiety or “salivary gland hypofunction”. Many doctors use the and depression, psychiatric disorders, or a hyperactive bladder. terms “xerostomia” and “hyposalivation” interchangeably Patients on multiple medications are particularly prone to because most (but not all) patients with xerostomia also have getting a dry mouth. An uncommon but important cause of dry hyposalivation. Sometimes your mouth may feel dry without it mouth is radiation therapy for head and neck cancer, during actually being dry (xerostomia without hyposalivation). Saliva which the salivary glands are irreversibly damaged. In diseases not only lubricates the mouth but also helps to fght infections, such as Sjögren syndrome (an autoimmune disease) and chronic so a reduction in the amount of saliva puts you at risk for graf-versus-host disease seen in bone marrow transplant discomfort in the mouth, and also may increase tooth decay recipients, the patient’s own immune system can damage the and yeast infections. salivary glands. Although it is normal to produce less saliva while sleeping, How do we know you have hyposalivation? patients with dry mouth commonly describe their mouths An experienced clinician can usually make the diagnosis by as feeling “parched”, “like sandpaper” or “like a desert” at all listening to the history and examining the patient.
    [Show full text]
  • Gastroenterology - Outpatient
    Gastroenterology - Outpatient Goal Gastroenterology encompasses the evaluation and treatment of patients with disorders of the gastrointestinal tract, pancreas, biliary tract, and liver. It includes disorders of organs within the abdominal cavity and requires knowledge of the manifestations of gastrointestinal disorders in other organ systems, such as the skin. Additional areas include knowledge of nutrition and nutritional deficiencies, and screening and prevention, particularly for colorectal cancer. The general internist should have a wide range of competency in gastroenterology and should be able to provide primary and in some cases secondary preventive care, evaluate a broad array of gastrointestinal symptoms, and manage many gastrointestinal disorders. The general internist is not expected to perform most technical procedures with the important exception of flexible sigmoidoscopy. However, he or she must be familiar with the indications, contraindications, interpretation, and complications of these procedures. Lead Faculty Grace Elta, MD Objectives 1 0 Patient Care and Medical Knowledge 1 1 Dysphagia Differentiate oropharyngeal from esophageal Know the general approach to diagnosis Oropharyngeal dysphagia Use of barium esophagogram/swallowing study Use of endoscopy Use of ENT/speech pathology Know the general approach esophageal dysphagia Use of endoscopy Use of barium esophagogram Know causes of esophageal dysphagia Rings GERD Stricture Pill esophagitis Cancer Know when to include radiology, gastroenterology 1 2 Gastroesophageal
    [Show full text]
  • Oropharyngeal Dysphagia: an Association Between
    DOI 10.20398/jscr.v11i1.20955 OROPHARYNGEAL DYSPHAGIA: AN ASSOCIATION BETWEEN DYSPHAGIA LEVEL, SYMPTOMS AND COMORBIDITY DISFAGIA OROFARÍNGEA: ASSOCIAÇÕES ENTRE O GRAU DE DISFAGIA, SINTOMAS E COMORBIDADES Lidiane Maria de Brito Macedo Ferreira¹; Kallil Monteiro Fernandes²; Cynthia Meira de Almeida Godoy³; Hipólito Virgilio Magalhães Junior4; Henrique de Paula Bedaque5. 1. Adjunct Professor at Otorhinolaryngology on Department of Surgery, Federal University of Rio Grande do Norte (UFRN). Natal-RN. Brazil. 2. Otorhinolaryngologist Physician. Natal-RN. Brazil. 3. Speech therapist on EBSERH (Empressa Brasileira de Serviços Hospitalares), UFRN. Natal-RN. Brazil. 4. Adjunct Professor at Department of Speech-Language and Hearing Sciences, UFRN. Natal-RN. Brazil. 5. Physician, Otorhinolaryngology resident. UFRN. Natal-RN. Brazil. Department of Surgery, Federal University of Rio Grande do Norte (UFRN), Brazil. Financial Support: None. Conflict of interest: None. Mailing address: Department of Surgery, Federal University of Rio Grande do Norte (UFRN), AV. Nilo Peçanha 620, Natal – RN, Brazil. E-mail: [email protected]. Submitted: may 18; accepted after revision, may 18, 2020. ABSTRACT Objective: Associate levels of dysphagia according to the patient health condition. Methods: Retrospective study analyzing 149 medical records of patients who underwent Fiberoptic endoscopic evaluation of swallowing (FEES) in a tertiary hospital from 2016 to 2018. Data was collected on symptoms, comorbidities, FESS findings and oropharynx dysphagia classification. Statistical analysis was performed through descriptive and bivariate analysis using the Chi-square and Fisher's exact tests with a 5% significance level. Results: Most patients are elderly, female and with the main complaint of gagging for liquids and solids (30.9%), and gagging only for liquids was associated with the presence of mild dysphagia.
    [Show full text]
  • Treatment of Gastrointestinal Radiation Injury with Hyperbaric Oxygen
    Rubicon Research Repository (http://archive.rubicon-foundation.org) UHM 2007, Vol. 34, No. 1 – Treatment of gastrointestinal radiation injury Treatment of gastrointestinal radiation injury with hyperbaric oxygen. G. T. MARSHALL1, R. C. THIRLBY1, J. E. BREDFELDT2, N. B. HAMPSON3 Submitted - 12/30/05 - Accepted 9/1/06 1Section of General Surgery, 2Section of Gastroenterology, 3Section of Pulmonary and Critical Care Medicine, Virginia Mason Medical Center Seattle, Washington Marshall GT, Thirlby RC, Bredfeldt JE, Hampson NB. Treatment of gastrointestinal radiation injury with hyperbaric oxygen. Undersea Hyperb Med 2007; 34(1):35-42. BACKGROUND: Chronic radiation enteritis develops in 5-20% of patients following abdominal and pelvic radiation. Current treatments are largely ineffective. OBJECTIVE: To assess the effectiveness of hyperbaric oxygen therapy (HBO2) as a treatment for chronic radiation enteritis and evaluate the relative effectiveness in treatment of the proximal and distal gastrointestinal tract. DESIGN: Case series of 65 consecutive patients with chronic radiation enteritis treated between July 1991 and June 2003 with HBO2. SETTING: A tertiary referral academic medical center. PATIENTS: 65 patients (37 male, 28 female; mean age 65 years) were treated with HBO2 for radiation damage to the alimentary tract. INTERVENTIONS: Patients were treated with an initial series of 30 daily treatments, each administering 90 minutes of 100% oxygen at 2.36 atmospheres absolute pressure. Thirty-two patients with partial symptom response or endoscopic evidence of healing received an additional 6 to 30 treatments. RESULTS: The primary indication for HBO2 was bleeding (n = 54) with 16 patients requiring transfusions. Additional indications were pain, diarrhea, weight loss, fistulas and obstruction.
    [Show full text]
  • Culture Advantage Anatomy and Medical Terminology For
    1 Culture Advantage Anatomy and Medical Terminology for Interpreters GASTROINTESTINAL SYSTEM Marlene V. Obermeyer, MA, RN [email protected] ©Culture Advantage http://www.cultureadvantage.org 2 Digestive System Case Study for PowerPoint Presentation Carlos is a 13-year old boy who is brought to the Emergency Department by his parents. Through an interpreter, the physician finds out that Carlos has started complaining of right lower quadrant pain about 16 hours ago. He was unable to eat supper, was nauseated and vomited several times. He is now feeling feverish and has pain all over his abdomen. An IV is started in his arm and he is given IV fluids and antibiotics. He is given medication for pain and given an antiemetic for nausea. He is also examined and interviewed by the physician. The physician obtains blood work that indicates Carlos has an acute infection. A CT scan of the abdomen indicates Carlos has appendicitis. A surgeon is contacted and Carlos is scheduled for emergency appendectomy. The interpreter is asked to translate the surgery consent form that states Carlos is going to have a "laparoscopic appendectomy, possible open laparotomy" and the parents are asked to sign the consent form. By the end of this section, you will learn the meaning of the following words: Acute IV (IV fluid, IV antibiotics) Antiemetic CT scan Appendicitis Appendectomy Laparoscopic appendectomy Open laparotomy ©Culture Advantage http://www.cultureadvantage.org 3 GASTROINTESTINAL SYSTEM TERMINOLOGY Terminology Meaning Terminology Meaning absorption The movement of Alimentary Alimen – nourishment. Refers food from the to the gastrointestinal or small intestine digestive tract into the cells of the body.
    [Show full text]
  • Geriatric Gi
    GERIATRIC GI EDMUNDO RODRIGUEZ- FRIAS, MD “We've put more effort into helping folks reach old age than into helping them enjoy it” GOALS OF TRAINING 1. Pathophysiology of aging. 2. Demographics and epidemiology of aging. 3. Impact of common geriatric disorders on gastroenterology. 4. Social and ethical issues in aging. 5. Listening skills and ethically sound relationship with elderly patient and their families. 6. Communicating bad news to the elderly. 7. Geriatric patients are a very heterogeneous population. 8. Effective strategies for inpatient and outpatient management. 9. Changes in gastrointestinal function with aging. 10. Changes in drug metabolism with aging. 11. Gastrointestinal effects of drugs. (BEERS list) 12. Effect of aging on nutrition. 13. Common gastrointestinal conditions in the elderly. BACKGROUND • Geriatric: >65yo and older, patients of advanced age: >80 years of age. • The U.S. Census Bureau projects the number of Americans >65 yo will more than double between 2010-2050. • Americans >65yo will grow from 13% to more than 20% of the total population by 2030, and the fastest growing segment of this group (individuals > 85) is expected to triple in number over the next four decades. • People living longer and the “baby boomer” generation crossed into the 65 and older age bracket in 2011. • Older adults account for a disproportionate share of healthcare services: o 26% of all physician office visits; o 35% of all hospital stays; o 34% of all prescriptions; o 38% of all emergency medical responses; and o 90% of all nursing home use. • In 2006, elderly underwent 35.3% inpatient and 32.1% outpatient procedures.
    [Show full text]
  • Chapter 10—Prevention
    CHAPTER 10—PREVENTION INTRODUCTION RECOMMENDED PREVENTIVE SERVICES OTHER PREVENTIVE SERVICES TO CONSIDER PREVENTIVE SERVICES NOT INDICATED IN OLDER ADULTS DELIVERY OF PREVENTIVE SERVICES ANNOTATED REFERENCES INTRODUCTION As the population ages and the average active life expectancy increases, issues of primary and secondary prevention become increasingly important. The prevalence of undetected, correctable conditions and comorbid diseases is high in older adults. Moreover, a growing number of older adults are enthusiastic and highly motivated about disease prevention and health promotion. The clinician provides the information and opportunity for preventive care that helps older patients to maintain functional independence for as long as possible. Many findings from research on preventive care and the appropriate components of periodic health examinations are inconclusive. In addition, older persons are typically not included in clinical trials of preventive strategies, which has limited the ability of geriatricians to adjust guidelines for preventive practices for patients aged 65 and older on the basis of new scientific findings. Primary care physicians are consequently compelled to rely on clinical judgment in planning the preventive care of their older patients. A number of factors, including age, functional status, comorbidity, patient preference, socioeconomic status, and the availability of care, affect health care decisions of the older adult. Unlike chronologic age, physiologic age may be determined by self-rated health and overall medical condition. Classifications that are based on life expectancy, physiologic age, and functional status may facilitate medical decision making with older patients. For example, the clinician might strongly recommend fecal occult blood testing (FOBT) to a healthy, functionally independent patient; discuss the potential pros and cons of FOBT and offer the test to a chronically ill, partially dependent patient; and actually recommend against FOBT for a severely frail, demented patient.
    [Show full text]