Alimentary Disorders 5

Alimentary Disorders 5

1. Liver Disease

   • Acquired, acute or chronic
   • V+, D+, weight loss, Jaundice, pale, fatty faeces due to decreased bile production
   • Biochemistry, bile acid stimulation test, ultrasound, liver biopsy
   • I.V fluids, antibiotics, water soluble bile acids, special diet

2. Colitis

   • Causes frequent passage of faeces, Tenesmus observed, contains blood or mucous
   • Bacteria, parasites, food intolerance, secondary to D+, secondary to tumours
   • Contrast Radiography (barium enema) proctoscopy, biopsy
   • Anti-inflammatories, antispasmodics, antibiotics, anthelmintics, high-fibre diet

3. Constipation

   • Abnormal quantity or frequency
     • Failure to pass faeces, tenesmus, hard faeces, V+, Dyschezia (pain when passing faeces)
     • Physical/ rectal examination, Radiography, Proctoscopy
   • Dietary: fibre too low, feeding bones?
   • Colonic: rectal strictures, foreign bodies, tumours, perineal ruptures, megacolon, anal sac disease.
   • Orthopaedic: pelvic fractures.
   • Dehydration, neurological dysfunction (Key Gaskell Syndrome), Prostatic hyperplasia
   • Enema, Alter diet, stool-softening agent, bulking agent, surgical correction of obstruction

4. ASSISTED FEEDING

   • ENTERAL
     • Hand-feeding
     • Tube-Feeding
       • Flush before & after use
   • TOTAL PARENTERAL NUTRITION
     • ASEPSIS & 24 HOUR MONITORING
     • Many complication so last resort
     • Central Venous Catheter placed