learning Objectives - Describe the various gastro intestinal disorders. Demonstrate skill in providing care for clients with gastro intestinal disorders.
Hours - 18
Teaching and Learning Activities - Lecture cum discussion Visit to endoscopy room, radiology department Demonstration Films and Videos
Assessment Methods - Short answer Objective type Essay type Return demonstration
Content of the chapter
a) Assessment of gastro intestinal function
– History
– Physical examination
– Diagnostic evaluation
b) Management of Upper gastrointestinal
disorders
– Parotitis
– Stomatitis
– Glossitis
– Gingivitis
– Pyorrhea
– Dental caries
– Halitosis
– Dysphagia
– Achalasiacardia
– Gastro Esophageal Reflux Disease (GERD)
– Cancer of esophagus
– Hiatus hernia
– Gastritis
– Gastric and duodenal ulcers
– Gastric cancer
– Gastroenteritis
– Esophageal fistula
– Peritonitis
c) Care of patient with gastro intestinal
intubation and special nutritional
management.
d) Management of patient with lower gastro
intestinal disorders:
– Helminthiasis
– Constipation
– Diarrhea
– Fecal incontinence
– Irritable Bowel Syndrome (IBS)
– Appendicitis
– Diverticular disease
– Crohn’s disease
– Ulcerative colitis
– Intestinal obstruction
– Colitis
– TB abdomen
– Colorectal cancer
– Polyps of colon and rectum
– Ano rectal abscess
– Anal fistula and fissure
– Hemorrhoids
e) Alternate therapies
f) Drugs used in treatment of GI disorders
Nursing Management of Patient with Gastro-Intestinal Disorders
Gastro-intestinal (GI) disorders affect digestion, absorption and elimination. Nursing management focuses on assessment, maintaining nutrition and hydration, relieving symptoms, preventing complications, and patient education.
a) Assessment of Gastro-Intestinal Function
1. History
- Present complaints:
- Abdominal pain, nausea, vomiting
- Diarrhea or constipation
- Heartburn, dysphagia
- Blood in stool or vomitus
- Dietary habits and appetite
- Weight loss or gain
- Past history of GI disorders
- Drug history (NSAIDs, antibiotics)
- Alcohol intake and smoking
- Family history of GI malignancy
2. Physical Examination
- Inspection
- Abdominal distension
- Scars, visible peristalsis
- Auscultation
- Bowel sounds (normal, hyperactive, absent)
- Percussion
- Tympany, dullness
- Palpation
- Tenderness, masses, organ enlargement
- Examine oral cavity and perianal area
3. Diagnostic Evaluation
- Stool examination (occult blood, parasites)
- Blood tests (CBC, LFT)
- Endoscopy / Colonoscopy
- Barium studies
- Ultrasound / CT abdomen
- Biopsy (if required)
b) Management of Upper Gastro-Intestinal Disorders
Oral and Esophageal Disorders
- Parotitis, Stomatitis, Glossitis, Gingivitis, Pyorrhea
- Maintain oral hygiene
- Warm saline mouthwash
- Antibiotics if infection
- Dental caries / Halitosis
- Dental care
- Oral hygiene education
- Dysphagia
- Soft or liquid diet
- Upright position during feeding
- Achalasia cardia
- Small frequent meals
- Esophageal dilatation care
- GERD
- Elevate head of bed
- Avoid spicy and fatty foods
- Antacids, PPIs
- Cancer of Esophagus
- Nutritional support
- Pre- and post-operative care
- Hiatus Hernia
- Lifestyle modification
- Avoid lying down after meals
Gastric Disorders
- Gastritis
- NPO initially if severe
- Antacids and PPIs
- Gastric & Duodenal Ulcers
- Avoid NSAIDs
- H. pylori treatment
- Monitor for bleeding
- Gastric Cancer
- Nutritional support
- Psychological care
- Gastroenteritis
- ORS and IV fluids
- Monitor dehydration
- Esophageal Fistula
- Maintain NPO
- Nutritional support
- Peritonitis
- IV antibiotics
- Monitor for shock
- Surgical preparation
c) Care of Patient with GI Intubation and Special Nutritional Management
GI Intubation (NG / Ryle’s tube)
- Verify tube placement
- Maintain patency
- Monitor drainage
- Provide oral and nasal care
Special Nutritional Management
- Enteral feeding (tube feeding)
- Parenteral nutrition (TPN)
- Monitor:
- Fluid balance
- Electrolytes
- Weight
d) Management of Lower Gastro-Intestinal Disorders
Common Conditions
- Helminthiasis
- Deworming drugs
- Hygiene education
- Constipation
- High-fiber diet
- Fluids and exercise
- Diarrhea
- ORS
- Monitor dehydration
- Fecal Incontinence
- Bowel training
- Skin care
- IBS
- Diet modification
- Stress management
- Appendicitis
- Pre- and post-operative care
- Diverticular Disease
- High-fiber diet
- Antibiotics if infected
- Crohn’s Disease & Ulcerative Colitis
- Anti-inflammatory drugs
- Nutritional support
- Intestinal Obstruction
- NPO
- NG suction
- Surgical care
- Colitis / TB Abdomen
- Antibiotics / Anti-TB drugs
- Colorectal Cancer
- Stoma care
- Nutritional and psychological support
- Polyps
- Colonoscopy care
- Ano-rectal Disorders
- Abscess: drainage care
- Fistula/fissure: hygiene, pain relief
- Hemorrhoids: Sitz bath, stool softeners
e) Alternate Therapies
- Diet therapy (fiber-rich diet)
- Yoga and relaxation techniques
- Probiotics
- Herbal remedies (under medical guidance)
- Lifestyle modification
f) Drugs Used in GI Disorders
- Antacids: Aluminium hydroxide
- PPIs: Omeprazole, Pantoprazole
- H₂ blockers: Ranitidine
- Antiemetics: Ondansetron, Metoclopramide
- Antidiarrheals: Loperamide
- Laxatives: Lactulose, Isabgol
- Antibiotics: As prescribed
- Anti-helminthics: Albendazole
- Anti-inflammatory drugs: Mesalamine
- Antispasmodics: Dicycloverine
Conclusion
Effective nursing management of GI disorders requires systematic assessment, maintenance of nutrition and hydration, symptom relief, prevention of complications, and patient education. Early nursing intervention greatly improves patient outcomes.