Common Gastrointestinal Problem

Subject: Geriatric Nursing (Theory)

Overview

Heartburn or gastroesophageal reflux is a burning sensation that occurs when contents from the stomach travel back up to the esophagus. Peptic ulcer refers to painful sores or ulcers in the lining of the stomach or the first part of the small intestine. Irritable bowel syndrome in Seniors is a condition that is quite a condition, the bowels function normally with a regular rhythmic movement of muscles along intestinal walls. When there are irregularities in the movement, digested food either speeds or slows down in the process to be eliminated from the body.

Heartburn/GERD

Heartburn or gastroesophageal reflux is a burning sensation that occurs when contents from the stomach travel back up to the esophagus and it affects more than 15 million Americans on a daily basis.

Symptoms

  • Heartburn
  • Nausea
  • Non-exertion chest pain when lying down or waking up
  • A bitter taste in the mouth
  • Food regurgitation in the mouth
  • Pain when swallowing
  • Food getting stuck while swallowing

Causes:

  • Spicy, greasy, fatty, or fried food
  • Lying down within two hours of eating
  • Some medications including calcium channel blockers, sedatives, tranquilizers, and asthma medication
  • Cigarette smoking
  • Eating large meals
  • Wearing tight clothing

Treatment

Medications

  • Antacids
  • H2 receptors antagonists
  • Proton pumps inhibitors

Surgery

The most common surgery for GERD is a laparoscopic procedure that involves tightening the esophageal sphincter.

Peptic ulcer

Peptic ulcer refers to painful sores or ulcers in the lining of the stomach or the first part of the small intestine. A peptic ulcer is a defect of the gastrointestinal mucosa that extends through the muscular mucosa because of the presence of acid and pepsin. Smoking and excessive alcohol intake also increase the risk of peptic ulcer disease.

Symptoms

  • Burning or pain
  • Indigestion
  • Heartburn
  • Loss of appetite
  • Being sick

Treatment

  • Proton pumps inhibitor
  • Antibiotics
  • If the ulcers are related to the use of NSAIDS, they are usually stopped and proton pump inhibitors are used.

Constipation

Constipation can have dangerous complications in older adults including acute changes in cognition, urinary retention, urinary incontinence, and fecal impaction. Fecal impaction from constipation can result in intestinal obstruction, ulceration, and urinary problems.

Cause 

  • Physiological changes with age
  • Endorphins
  • Declined in internal sphincter tone
  • Retake sensation and tone
  • Psychological factors like depression and cognitive impairment
  • Medications/drugs like anticholinergic properties, antacids containing aluminum or calcium and calcium channel blockers, NSAIDs, Antihistamines, Antiparkinsonian agents, iron preparations, Diuretics
  • Diet and exercise

Treatment

  • Physical activity, exercise
  • Fluid and fiber intake
  • Encourage for the daily routine of defecation
  • Laxatives can be used.

Hemorrhoids

The blood vessels become present particularly in the lowest parts of the guts, the wall of the rectum and anus are swollen which is known as hemorrhoids or commonly known as piles. It is more frequently seen in the elderly who tend to suffer from bowel conditions such as constipation.

Causes

  • Constipation or diarrhea
  • Obesity

Symptoms

  • Bleeding during and after bowel movements
  • Itching and discomfort of the anus
  • Pain and burning in the anus
  • Anal leakage were fluid and specks of feces soil in underwear
  • Swelling and painful lumps in the anal region.

Treatment and management

Treatment of hemorrhoids can be either medical or surgical and involves conservative measures as well. Medical treatment involves the use of ointment, suppositories, and other topical applications which help to relieve symptoms of hemorrhoids. At the same time, conservative measures need to be instituted such as:

  • Drink plenty of water
  • High-fiber foods and fiber supplements
  • Avoid sitting on the toilet for too long and straining to pass stool
  • Exercise and weight loss

Surgical measures are necessary for hemorrhoids that don’t respond to the measures above. Some of these procedures are minor and aimed at shrinking the veins. Other major procedures may remove the vein or shrink the vein.

Irritable Bowel Syndrome

Irritable bowel syndrome in Seniors is a condition that is quite a condition, the bowels function normally with a regular rhythmic movement of muscles along intestinal walls. When there are irregularities in the movement, digested food either speeds or slows down in the process to be eliminated from the body. This creates episodic periods of diarrhea and periods of constipation.

Symptoms

  • A sense of incomplete bowel movement
  • Abdominal pain, gas or bloating
  • Irregularities in stool composition
  • Mucous in the stool

Treatment and management

  • A diet low in fat and high in carbohydrates and fiber can also help with symptoms
  • Fiber supplements
  • Some medications such as antispasmodics, tranquilizers, or antidepressants are helpful

Prevention

  • Avoid smoking and second-hand smoke
  • Decreasing intake of constipation foods such as cheese
  • Drinking adequate water daily
  • Eating smaller regular meals rather than one large meal
  • Eliminating caffeine or other dietary stimulants
  • Exercise regularly
  • Reducing intake of irritants foods such as spicy, fried, and fatty foods
  • Supplementing the diet with bulk-forming or fiber products
  • Using laxatives only when recommended by health professionals.

Diverticulosis

Diverticulitis is a condition that develops when pouches form in the wall of the colon. Diverticula can occur throughout the gastrointestinal tract but are seen most commonly in the sigmoid and descending colon.

Risk factors

  • Unnoticed muscle spasms or pairs of muscles that don’t contract in a synchronized manner
  • Low-fiber diet
  • Lack of exercise
  • Being overweight

Management

Patient with diverticula is treated to minimize avert the possibility of diverticulitis. Medications don't usually help, but a high roughage diet and sometimes bran or psyllium seed preparations such as Metamucil or Protein can help.

Gaint diverticula need to be removed surgically. Giant diverticula are removed along with a small section of the colon, and the two loose ends of the colon are sutured back together. This is called segmental resection of the colon.

Mild diverticulitis can be treated at home with rest, a liquid diet, and antibiotics.

Things to remember
  • Heartburn/GERD Heartburn or gastroesophageal reflux is a burning sensation that occurs when contents from the stomach travel back up to the esophagus and it affects more than 15 million Americans on a daily basis.
  • Smoking and excessive alcohol intake also increase the risk of peptic ulcer disease.
  • Irritable Bowel Syndrome Irritable bowel syndrome in Seniors is a condition that is quite a condition, the bowels function normally with a regular rhythmic movement of muscles along intestinal walls.
  • Diverticulosis Diverticulitis is a condition that develops when pouches form in the wall of the colon.
  • Gaint diverticula need to be removed surgically.

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