Transcript Crohn`s Disease

Overview – March 7
 Clinical Applications
 Sjogren’s Syndrome
 Acid Reflux Disease
 GERD: Gastroesophageal Reflux Disease
 Gall Bladder Disease
 Crohn’s Disease
 Appendicitis
Digestive System: Overview
Figure 23.1
Sjogren’s Disease
 Dry eyes and dry mouth
 Autoimmune disease
 Inflammation of glands of body
 Glands that produce tears
 Glands that produce saliva
 Cause is unknown
 Genetic associations
 90% of patients are females
Salivary Glands
Figure 23.9a
Symptoms
 Mouth dryness
 Difficulty in swallowing
 Mouth sores and tooth and gum disease
 Saliva crystals and infection of parotid glands
 Heartburn from acid reflux
Treatment
 No cure is available
 Drink plenty of fluids
 Humidify air
 Sucking on sugarless lemon drops
 Drugs: saliva stimulants
 Artificial saliva
 Diligent dental care
Acid Reflux Disease
 Stomach is filled with acids to help digest foods
 Very strong acids in stomach
 Acid backup into esophagus
 Heartburn
 Heartburn 2 or more days per week for at least 3 mos
 Acid reflux disease
 Valve separating the esophagus from the stomach does not
close properly (esophageal sphincter)
 Chronic heartburn
 Can lead to more serious medical complications
 Erode lining of esophagus
Microscopic View of the Lining of the Digestive Tract
Esophageal Sphincter
Normal
GERD
Lifestyle Treatments
 Diet – avoid:
 Fatty and fried foods
 Chocolate
 Peppermint
 Citrus fruits
 Tomato juice
 Alcohol
 Coffee
 Cold or spicy foods
Lifestyle Treatments (con’t)
 Avoid tight clothes and tight belts
 Raise head about 6-9 inches when supine
 Avoid excessive bending, lifting and stooping
Treatment
 Medications
 Antacid
 Neutralizes acid that backs up into esophagus
 Salts of magnesium, calcium, and aluminum
bicarbonate
 Turn off acid pumps in stomach (Nexium – ‘the
purple pill’, Pepcid)
 Can also heal esophageal erosion
Pillcam
Swallow pill and view digestive tract
camera
transmitter
Alternative to endoscopy
Pill moves through digestive tract by peristalisis
Eliminated from body 12-24 hrs later
Gall Bladder Disease
 Includes inflammation, infection, gall stones, gall
bladder obstruction
 Trapped bile
 Becomes more concentrated
 Causes irritation, infection, perforation
 Conditions which slow or obstruct flow of bile out
of gall bladder
 Cholescyctitis (inflammation of gall bladder)
 Gall stones
Gall Bladder Position
Gallbladder and Associated Ducts
Figure 23.20
Symptoms
 Abdominal fullness or gas
 Abdominal pain –right side or upper middle abdomen
 Occurs after meals; particularly after fatty food intake
 Worse during intake of deep breath
 Pain under sternum
 Fever and chills
 Nausea and vomiting
 Heartburn
Treatment
 Gall bladder removal
 Open surgery – large abdominal cut through
abdominal muscles
 Laparoscopic surgery
 4 tiny incisions in abdomen
Gall Bladder Laparoscopic Surgery
Crohn’s Disease
 Chronic inflammation of digestive tract (type of
inflammatory bowel disease)
 Most commonly affects lower small intestine (ileum)
 ileitis
 Swelling deep into lining of wall of affected area
 Severe pain
 Severe diarrhea
 Higher rates among Jewish people
 African Americans at lower risk for disease
Digestive System: Overview
Figure 23.1
Causes of Crohn’s Disease
 Several theories
 Autoimmune disease
 Own body’s immune system attacks digestive
system
 Accumulation of white blood cells in intestinal
lining
 Causes chronic inflammation
Treatment
 65-75% of patients with Crohn’s disease need surgery
 Relief of symptoms
 Correct complications
 Blockages
 Perforation (tear in intestinal lining)
 Bleeding
 Remove part of small intestine
 Large intestine
 Need colectomy – remove large intestine
 Ileum (base of small intestine) is brought to surface and
pouch is attached to collect waste
Crohn’s Disease
Normal ileum
Ileum with Crohn’s disease
Diet, Drug Therapy and Crohn’s Disease
 Decreased appetite
 Diarrhea and poor absorption of nutrients
 Nutritional supplements
 High calorie liquid supplements
 Intravenous feeding
 Reduce fiber, alcohol, milk, spices
 Drugs
 Antibiotics
 Steriods
 Immune system suppressors
 Anti-diarrheal and fluid/electrolyte replacements
Appendicitis
 Appendix attached to cecum (large intestine)
 Produces mucus and antibodies
 Delivered to colon
 When opening from appendix to colon is blocked
 Excessive mucus or stool
 Bacteria invade wall of appendix
 Inflammation
 Surgery to remove appendix
Digestive System: Overview
Figure 23.1
Inflamed Appendix