Gastrointestinal Elimination
7.3 Conditions and Diseases of the Gastrointestinal System
Amanda Egert; Kimberly Lee; and Manu Gill
In this section, we will review common conditions and diseases related to the gastrointestinal system and elimination including hyperacidity, diarrhea, constipation, nausea, and vomiting.
Hyperacidity and Ulcers
Acid-related diseases can occur when there is an imbalance of secretions by the surface epithelium cells in the stomach.
The most common mild to moderate hyperacidic condition is gastroesophageal reflux disease (GERD), often referred to by clients as heartburn, indigestion, or sour stomach. GERD is caused by excessive hydrochloric acid that tends to back up, or reflux, into the lower esophagus. See Figure 7.3a for an illustration of GERD.[1]
Peptic ulcer disease (PUD) occurs when gastric or duodenal ulcers are caused by the breakdown of GI mucosa by pepsin, in combination with the caustic effects of hydrochloric acid. PUD is the most harmful disease related to hyperacidity because it can result in bleeding ulcers, a life-threatening condition.
Stress-related mucosal damage is another common condition that can occur in hospitalized clients leading to PUD. Thus, many post-operative or critically ill clients receive medication to prevent the formation of a stress ulcer, which is also called stress ulcer prophylaxis.[2] See an image of a duodenal ulcer in Figure 7.3b.[3]
Here are some additional links to supplementary videos illustrating heartburn and gastric ulcers:
Diarrhea
Diarrhea itself is not a disease but is a sign and symptom of other conditions and disease processes in the body.
Diarrhea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Frequent passing of formed stools is not considered diarrhea. Diarrhea has multiple causes such as bacteria from contaminated food or water; viruses such as influenza, norovirus, or rotavirus; parasites found in contaminated food or water; medicines such as antibiotics, cancer drugs, and antacids that contain magnesium; food intolerances and sensitivities; and diseases that affect the colon, such as Crohn’s disease or irritable bowel syndrome.[6]
The most severe threat posed by diarrhea is dehydration caused by the loss of water and electrolytes. Diarrheal disease is a leading cause of child mortality and morbidity throughout the world due to dehydration; frail elderly are also at risk. When severe diarrhea occurs, assessment for dehydration and electrolyte imbalances receive top priority and rehydration with oral rehydration solutions or IV fluids may be required.[7]
Constipation
Constipation is defined as “three or fewer bowel movements in a week; stools that are hard, dry or lumpy; stools that are difficult or painful to pass; or the feeling that not all stool has passed.”[8] If defecation is delayed for an extended time, additional water is absorbed, thus making the feces firmer and po