11.3 General Assessment of the Gastrointestinal System (151/84) -- Health Alterations

11.3 General Assessment of the Gastrointestinal System When evaluating a client with a potential gastrointestinal disorder, the nurse must pay special attention to their particular risk factors, as well as the influence of their cultural beliefs and socioeconomic factors. All these factors may affect their overall gastrointestinal health, as well as their response to treatment. Risk Factors There are several risk factors that, when present, can contribute to the development of gastrointestinal (GI) disorders, including the following[1],[2],[3],[4],[5]: - Diet can play a large role in the development of gastrointestinal disorders. For instance, a low-fiber diet puts the client at risk for constipation, as well as diverticulosis. The use of alcohol can contribute to gastroesophageal reflux disease and can lead to impaired nutrition absorption and increased incidence of diarrhea, as well as the risk of esophageal cancer. Diets high in fat have also been linked to inflammatory bowel disease, as well as the immune health of the gastrointestinal system. - Inactivity puts the client at risk for constipation due to reduced GI motility. Inactivity also promotes obesity, which is a risk factor for a variety of gastrointestinal disorders. - The use of certain medications such as iron supplements and opioids can contribute to constipation. - A family history of GI disorders can put the client at elevated risk. For instance, colon cancer and inflammatory bowel disease tend to run in families. - Age is also a significant risk factor. The elderly undergo a number of physiologic changes that predispose them to gastrointestinal issues. For instance, elderly clients tend to experience alterations in taste, which may put them at risk for malnutrition. Elderly clients have a reduction in LES pressure, predisposing them to gastroesophageal disease. Additionally, they also have a reduction in blood flow to the stomach and decreased protective systems, putting them at greater risk for peptic ulcer disease. - Stress resulting from acute illnesses and burns can contribute to the development of peptic ulcer disease. Cultural Factors A variety of cultural factors can also influence health and illness as it relates to the gastrointestinal tract. A client’s ethnic heritage can affect how a gastrointestinal disorder presents. For instance, African Americans with inflammatory bowel disease tend to have more complex GI disorders and suffer from more complications when compared to other ethnicities. Food also plays a significant role in cultural traditions and can, therefore, affect the gastrointestinal system. For example, clients who are vegan avoid the ingestion of animal products. Therefore, nurses must take cultural beliefs into account when counseling the client on dietary intake as it relates to a particular disorder.[6] Client terminology and language can also be important when assessing the client’s gastrointestinal system. Bloating is a common symptom of many GI disord