Alimentary Tract Diseases Flashcards
What is regurgitation?
- Expulsion of undigested food/liquid from oesophagus/larynx
- Passive process (no abdominal contractions)
- Often shortly after eating
- May lead to malnutrition, weight loss and aspirating pneumonia
What are some possible causes of regurgitation relating to oesophageal disease?
- Megaoesophagus (oesophagus becomes flaccid, weak and dilated)
- Foreign body
- Oesophagitis
- Oesophageal stricture (narrowing usually caused by ingesting foreign material, eg toy/rope)
- Persistent right aortic arch (Abnormal rerouting of the blood vessels in the aorta
- Hiatal hernia (Forms at opening in diaphragm where oesophagus joins stomach)
- Neoplasia (various types of abnormal growths/tumours)
What are some other causes of regurgitation (not relating to oesophageal disease)?
- Neuromuscular (myasthenia gravis)
- Myopathies
- Neuropathies
- Central nervous system disease
- Lactating bitch
- Infectious (rabies, botulism)
What diagnostics can be done for a patient presenting with regurgitation?
- Blood samples (haematology and biochemistry)
- Plain and barium swallow radiographs (water soluble contrast preferred)
- Endoscopy
What treatments can be done for regurgitation?
Treat underlying cause:
- Megaoesophagus = conservative management
- Oesophagitis = antiinflammatories and antacids (omeprazole & antihistamines)
- Foreign bodies = removal
- Oesopageal strictures = ballooning
- PRAA/hiatal hernia/neoplasia = surgery
What nursing care can be done for a regurgitating patient?
- Monitor hydration and vitals
- Monitor and record weight
- Observe regurgitation and record
- Observe signs of aspiration pneumonia
- Small volumes of concentrated diet
- Pastural feeding (let gravity assist movement = high feeding)
- Fluids and electrolytes
What is vomiting?
- Active process
- involves expulsion of contents from the stomach and/or upper small intestine
- Involves contraction of abdominal muscles
- Signs of nausea may be seen before emesis (eg hyper salivation, lip licking, abdominal pain, behaviour changes, eating grass)
- Common clinical sign of many conditions as it is a protective mechanism
- Can be classed as acute or chronic
- Dehydration may occur depending on frequency and volumes involved
- May also lead to electrolyte imbalances
What are some possible causes of vomiting and some examples?
Primary GI Disease
- Adverse reaction to food
- GI infection
- Parasitism
- Gastric ulceration
- Gastric neoplasia
- Gastric foreign body
- Gastrointestinal ischaemia (decreased blood flow to GI tract)
- Gastrointestinal obstruction
Secondary causes
- Motion sickness
- Causes of sepsis (pyometra)
- Renal disease (due to uraemia)
- Disease of pancreas/liver
- Pain, fear, psychogenic
What diagnostics can be done for a vomiting patient?
- Detailed clinical history
- Observation and clinical exam of patient
- Blood tests
- Abdominal X-rays and/or ultrasound
- Barium swallow radiographs
- Gastroscopy
- Exploratory laparotomy
- Biopsy
What treatment and nursing care can be done with a vomiting patient?
- Isolate and barrier nurse
- Treat underlying cause
- Replace fluids and electrolytes
- Period of starving (if uncomplicated acute V+ starve for 24 hours)
- Dietary modification
- Anti-emetics
- Gastric protectants and antacids
- Analgesia
- Clean/groom patient
- Monitor vomiting, weight and hydration status
What is GDV?
Gastric Dilation-Volvulus
What clinical signs may be seen with a GDV patient?
- Collapse
- Severe hypovolaemic shock
- Unproductive wretching
- Distended stomach
- Tachycardia and possibly arrhythmias
- Pale MMs and slow CRT
- Restlessness
- Hypersalivation and tachypnoea
How is GDV diagnosed?
Right lateral X-ray (abdominal)
What treatment and nursing care can be done for a GDV patient?
- Immediate decompression (large bore stomach tube through centre of roll of tape in mouth), percutaneous trocarisation = immediate release of gas and fluid
- Aggressive shock fluid therapy
- IV AB’s
- Treatment/monitoring of cardiac arrhythmias
- Corrective surgery (gastropexy)
Post op:
- Starve for 12 hours and slowly introduce oral liquids (bland, easily digestible)
- Monitor for signs of shock
What is pancreatitis caused by?
Self-digestion (autolysis) of pancreas by the digestive enzymes
