Digestive Diseases

Learning Objectives 

After completing this course you will be able to:

  1. List four various digestive diseases, prevalence, mortality, hospitalizations, physician office visits, prescriptions and costs.
  1. Separate facts and fallacies about digestive diseases.
  2. Discuss with the patient causes of hiatal hernia, heartburn, peptic ulcer disease, celiac sprue, inflammatory bowel disease, pancreatitis and cirrhosis.
  1. Explain how food is digested.
  2. Describe the movement of food through the digestive system.
  3. Explain how digestive juices are crucial to the process of digestion.
  4. Describe how carbohydrates, protein, fats, vitamins, and water and salt are absorbed and transported from the digestive system.
  5. Explain how hormone and nerve regulators control the digestive process.
  1. For the digestive organs (esophagus, stomach, intestine, and liver) list various over the counter and prescription medicines that can cause harmful effects.
  2. List warning signs and precautions to be taken for the following digestive disorders: irritation of the esophagus and the stomach, esophageal reflux, delayed emptying of the stomach, constipation, diarrhea, and liver problems.
  1. Define irritable bowel syndrome, and distinguish it from other, more serious organic disorders, such as colitis, spastic colon, and functional bowel disease.
  2. Discuss causes of IBS, list its symptoms and describe the role of diet and stress in treating IBS.
  1. Define gastroesophageal reflux.
  2. List at least 5 factors that contribute to GERD
  3. List 6 tips to control heartburn.
  4. Discuss diagnostic procedures for the assessment of GERD
  5. The movement of bile cells from the intestine to the stomach to produce a more harmful reflux material.
  1. List two main causes of gas in the digestive tract.
  2. List various foods that cause gas in the following categories: sugars, starches and fiber
  3. Describe four most common symptoms of gas.
  4. Discuss three common ways to reduce the discomfort of gas.
  1. Define constipation
  2. List 11 common causes of constipation.
  3. List 11 diseases that cause constipation.
  4. Describe four diagnostic tests and physical examinations that are necessary proper assessment of constipation.
  5. Describe four treatments for constipation.
  1. Identify 11 causes of bleeding in the digestive tract.
  2. List 5 ways of recognizing blood in the stool and vomit.
  3. List 6 symptoms of acute bleeding and four symptoms of chronic bleeding.
  4. Describe at least five diagnostic techniques of detecting bleeding in the digestive tract.
  5. Discuss two major treatment procedures for bleeding in the digestive tract.
  1. Define lactose intolerance and describe three tests to diagnose lactose intolerance.
  2. Discuss two primary methods of treating lactose intolerance.
  3. Identify eight categories of food products that may contain lactose.
  1. Define ulcer and identify three factors that cause ulcer development.
  2. Discuss the role of H. pylori in the development of ulcer.
  3. Discuss the treatment of ulcers in terms of lifestyle changes, medicines, and surgery.
  4. Describe the treatment with antibiotics for patients with h.pylori.
  5. Describe three common types of surgery for patients with ulcers.
  1. Describe 4 symptoms of hemorrhoids.
  2. Discuss three treatments for hemorrhoids, including four surgical treatments for the removal of hemorrhoids.
  3. Identify four preventive measures for hemorrhoids
  1. Describe Diverticulosis and Diverticulitis and discuss their symptoms and their treatments.
  2. Distinguish between Diverticulosis and Diverticulitis.
  1. Describe the digestive tract affected by Crohn’s disease.
  2. Discuss causes, treatment and control of Crohn’s disease.
  1. Identify the areas of the digestive tract that are usually affected by ulcerative colitis.
  2. Discuss causes and treatment for ulcerative colitis.
  1. Identify at least four major causes of cirrhosis.
  2. Discuss at least six symptoms of cirrhosis.
  1. Describe two types of gallstones, cholesterol stones and pigment stones.
  2. Discuss at least four causes of gallstones.
  3. Identify seven groups of people who are most likely to develop gallstones.
  4. Describe and distinguish between two kinds of gallbladder surgery.
  1. Identify at least four causes of acute pancreatitis and describe three symptoms of acute pancreatitis.
  2. Distinguish between acute and chronic pancreatitis.
 

Learning Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.

Contents


1.Basics

v  Facts and Fallacies About Digestive Diseases

Ulcers

Heartburn

Celiac Disease

Bowel Regularity

Constipation

Irritable Bowel Syndrome

Diverticulosis

Inflammatory Bowel Disease

Cirrhosis

Ostomy Surgery
v Digestive Diseases Statistics

Specific Diseases

Additional Data

Glossary
v  Your Digestive System and How It Works

Why is digestion important?

How is food digested?

Movement of Food Through the System

Production of Digestive Juices

Absorption and Transport of Nutrients

How is the digestive process controlled?

Hormone Regulators

Nerve Regulators
v  Smoking and Your Digestive System

Harmful Effects

Heartburn

Peptic Ulcer

Liver Disease

Crohn’s Disease

Gallstones

Can the damage be reversed?

For more information
2.  Foodborne Illness
v  Bacteria and Foodborne Illness

Causes

Symptoms

Risk Factors

Complications

Diagnosis

Treatment

Prevention

Food Irradiation

Links to Other Disorders

Common Sources of Foodborne Illness

Points to Remember
v  Viral Gastroenteritis

Symptoms

Causes

Transmission

Diagnosis

Treatment

Prevention

Points to Remember
3.  Common Digestive Problems
v  Indigestion
v  What I Need to Know About Constipation

Disease Definition

Clinical Presentation and Natural History

What is constipation?

What can I do about constipation?

Points to Remember
v  Constipation in Children
v  Lactose Intolerance

What is lactose intolerance?

How is lactose intolerance diagnosed?

How is lactose intolerance treated?

How is nutrition balanced?

What is hidden lactose?

Summary
v  Gas in the Digestive Tract

What causes gas?

Swallowed Air

Breakdown of Undigested Foods

Which foods cause gas?

What are some symptoms and problems of gas?

Belching

Flatulence

Abdominal Bloating

Abdominal Pain and Discomfort

What diagnostic tests are used?

How is gas treated?

Diet

Nonprescription Medicines

Prescription Medicines

Reducing Swallowed Air

Conclusion

Points to Remember
v  Bleeding in the Digestive Tract

What causes bleeding in the digestive tract?

What are the common causes of bleeding in the digestive tract?

Esophagus

Stomach

Small Intestine

Large Intestine and Rectum

How is bleeding in the digestive tract recognized?

How is bleeding in the digestive tract diagnosed?

Endoscopy

Other Procedures

How is bleeding in the digestive tract treated?

How do you recognize blood in the stool and vomit?

What are the symptoms of acute bleeding?

What are the symptoms of chronic bleeding?

For more information
v  Fecal Incontinence

Causes

Constipation

Muscle Damage

Nerve Damage

Loss of Storage Capacity

Diarrhea

Pelvic Floor Dysfunction

Diagnosis

Treatment

Dietary Changes

Medication

Bowel Training

Surgery

What to do about anal discomfort

Emotional Considerations

Everyday Practical Tips

Fecal Incontinence in Children

Why children get constipated

Hope Through Research

For more information
v  Infectious Diarrheas

Summary

Definition and Diagnosis

Risk Factors and High-Risk Groups

Child Day-Care Centers

Bacterial Diarrheas

Salmonellosis

Shigellosis

E. Coli 0157:h7–Hemorrhagic Colitis

Viral Diarrheas
4.  Miscellaneous Disorders
v  Appendicitis

Causes

Symptoms

People With Special Concerns

Diagnosis

Medical History and Physical Examination

Laboratory Tests

Imaging Tests

Treatment

Surgery

Antibiotics and Other Treatments

Complications

Prevention

Points to Remember
v  Hemorrhoids

Clinical Epidemiology of Hemorrhoids

What are hemorrhoids?

What are the symptoms of hemorrhoids?

How common are hemorrhoids?

How are hemorrhoids diagnosed?

Diagnosis

What is the treatment?

How are hemorrhoids prevented?
v  Gallstones

Diet and Alcohol

What are gallstones?

What causes gallstones?

Cholesterol Stones

Pigment Stones

Other Factors

Who is at risk for gallstones?

What are the symptoms?

How are gallstones diagnosed?

What is the treatment?

Surgery

Nonsurgical Treatment

Don’t people need their gallbladders?

Points to Remember
v  Diverticulosis and Diverticulitis

Summary

Definitions

Current Means of Diagnosis

Natural History

Prevention

Diverticulum, diverticulosis, diverticulitis

What causes diverticular disease?

What are the symptoms?

Diverticulosis

Diverticulitis

What are the complications?

Bleeding

Abscess, Perforation, and Peritonitis

Fistula

Intestinal Obstruction

How does the doctor diagnose diverticular disease?

What is the treatment for diverticular disease?

Diverticulosis

Diverticulitis

When is surgery necessary?

Points to Remember

Additional Readings
v  Wilson’s Disease
v  Gastroparesis and Diabetes

What is gastroparesis?

Signs and Symptoms

Complications of Gastroparesis

Major Causes of Gastroparesis

Diagnosis

Treatment

Insulin for Blood Glucose Control

Medication

Meal and Food Changes

Feeding Tube

Parenteral Nutrition

New Treatments

Hope Through Research

Points to Remember
v  Rapid Gastric Emptying
v  Gastritis
v  Proctitis
v Pancreatitis

Acute Pancreatitis

Symptoms

Diagnosis

Treatment

Complications

Gallstones and Pancreatitis

Chronic Pancreatitis

Symptoms

Diagnosis

Treatment

Pancreatitis in Children

Points To Remember

Hope Through Research
v  Short Bowel Syndrome
v  Inguinal Hernia
v  Intestinal Adhesions

Symptoms

Diagnosis

Treatment

Prevention
v  Cyclic Vomiting Syndrome

The Four Phases of CVS

Triggers

CVS and Migraine

Symptoms

Diagnosis

Treatment

Complications

Points to Remember
v  Hirschsprung’s Disease

What is Hirschsprung’s disease?

Why does HD cause constipation?

What causes HD?

If I have more children, will they have HD too?

What are the symptoms?

Symptoms in Newborns

Symptoms in Young Children

Symptoms in Teenagers and Adults

How does the doctor find out if HD is the problem?

Barium Enema X Ray

Manometry

Biopsy

What is the treatment?

Pull-through Surgery

Colostomy and Ileostomy

What will my child’s life be like after surgery?

Ostomy

Adjusting After Pull-through

Diet and Nutrition

Infection

Points to Remember

Acknowledgments
v  Clostridium Difficile Infection

For more information
5.  Hepatitis
v  Viral Hepatitis: A Through E and Beyond

Symptoms of Viral Hepatitis

Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis D

Hepatitis E

Other Causes of Viral Hepatitis

Hope Through Research
v  Autoimmune Hepatitis

Autoimmune Disease

Symptoms

Diagnosis

Treatment

Side Effects

Other Treatments

Hope Through Research

Points to Remember
v  What I Need to Know About Hepatitis A

What is hepatitis A?

What causes hepatitis A?

How could I get hepatitis A?

Who can get hepatitis A?

What are the symptoms?

How is hepatitis A treated?

How can I protect myself?
v  What I Need to Know About  Hepatitis B

What is hepatitis B?

What causes hepatitis B?

How could I get hepatitis B?

What are the symptoms?

What are the tests for hepatitis B?
v  Vaccinations for Hepatitis A and B

Candidates for Hepatitis A Vaccination

Routine Vaccination

High-Risk Populations

Postexposure Prophylaxis

Candidates for Hepatitis B Vaccination

Routine Vaccination

High-Risk Populations

Postexposure Prophylaxis

Combination Vaccine

References
v  What I Need to Know About Hepatitis C

What is hepatitis C?

What causes hepatitis C?

How could I get hepatitis C?

Could I get hepatitis C from a blood transfusion?

What are the symptoms?

What are the tests for hepatitis C?

How is hepatitis C treated?

How can I protect myself?
v  Chronic Hepatitis C: Current Disease Management

Introduction

Risk Factors and Transmission

Maternal-Infant Transmission

Sexual Transmission

Sporadic Transmission

Unsafe Injection Practices

Clinical Symptoms and Signs

Clinical Features of Cirrhosis

Extrahepatic Manifestations

Serologic Tests

Enzyme Immunoassay

Recombinant Immunoblot Assay

Direct Assays for HCV RNA

Quantification of HCV RNA in Serum

Genotyping and Serotyping of HCV

Biochemical Indicators of Hepatitis C Virus Infection

Normal Serum ALT Levels

Liver Biopsy

Serum Markers of Hepatic Fibrosis

Diagnosis

Acute Hepatitis C

Chronic Hepatitis C

Differential Diagnosis

Treatment

Who Should Be Treated?

Who Should Not Be Treated?

Side Effects of Treatment

Options for Patients Who Do Not Respond to Treatment

Hope Through Research

Basic Research

Diagnostic Tests

New Treatments

Prevention

Selected Review Articles and References
v  Cirrhosis of the Liver

Causes

Symptoms

Complications of Cirrhosis

Diagnosis

Treatment
v  Primary Biliary Cirrhosis
v  Primary Sclerosing Cholangitis
v  Nonalcoholic Steatohepatitis

Diagnosis

Symptoms

Causes

Treatment

Hope Through Research

Points to Remember
v  What I Need to Know About Liver Transplantation

What does my liver do?

What are the signs of liver problems?

What is liver transplantation?

What are the reasons for needing a liver transplant?

How will I know whether I need a liver transplant?

Can anyone with liver problems get a transplant?

How long does it take to get a new liver?

Where do the livers for transplants come from?

Health insurance

What happens in the hospital?

During Surgery

After Surgery

What is rejection?

How is rejection prevented?

Do immunosuppressants have any side effects?

What are the signs of rejection?

What are the other problems that can damage the liver transplant?

What if the transplant doesn’t work?

How do I take care of my liver after I leave the hospital?

Can I go back to my daily activities?

Glossary
6.  Diagnostic Tests
v  ERCP (Endoscopic Retrograde Cholangiopancreatography)

Preparation
v  Liver Biopsy

Preparation

Procedure

Recovery
v  Colonoscopy

Preparation
v  Virtual Colonoscopy

VC Procedure

Advantages of VC

Disadvantages of VC
v  Flexible Sigmoidoscopy

Preparation
v  Lower GI Series

Preparation
v  Upper GI Series

Preparation