TREATMENTThe objective of treatment
is to reestablish regular evacuation of feces. The
diet is of primary concern. The patient should be
instructed to maintain an adequate intake of food.
Many times an inadequate food intake alone is
sufficient to cause constipation. Foods consumed
should have a high fiber content, such as bran,
raw fruits, and vegetables. Encourage the patient
to force fluids, exercise, and take mild laxatives.
Laxatives should be administered only until
constipation is improved.
Nausea and Vomiting
Nausea and vomiting may be attributed to a
wide variety of causes and may reflect underlying
GI or systemic disease. Severe complications such
as aspiration or esophageal rupture may result.
TREATMENTIn the treatment of simple
acute nausea and vomiting, little or no treatment
is required. In more severe cases, force fluids to
prevent dehydration and give antispasmodic
drugs, such as Compazine®, to combat nausea.
Treat the underlying cause.
Psychologic GI Disorders
Abdominal pain may have many names, such
as indigestion or dyspepsia, and may involve all
or a portion of the GI tract. It is frequently
caused by improper diet or irregular meals as well
as poor living and hygiene habits.
SYMPTOMSThe symptoms produced are
varied. They include hyperirritability, altered
motility and secretion of the GI tract, foul
breath, cramps, diarrhea, and flatulence. Often
there is a history of nervousness and emotional
TREATMENTThe patient should be in-
structed about personal and living habits and
hygiene. Emphasize adequate and regular sleep,
nourishing meals, and exercise. Treat sympto-
Upper GI Hemorrhage
This is rather a common medical emergency.
It results from such conditions as peptic ulcer
perforation, gastritis, and esophageal varices.
SYMPTOMSThe patient may complain of
weakness, fainting, or melena. Hematemesis is
common. Shock may or may not be present. Loss
of large amounts of blood volume produces
TREATMENTGeneral measures include
absolute bed rest, recording intake and output,
nasogastric suction, ice water or ice and antacid
lavages, monitoring vital signs at least once per
hour, replacing blood volume, and treating for
shock. Keep the patient NPO for the first 24
hours. If the bleeding has subsided, start a liquid
diet. Mild sedation may be indicated. For cases
involving ulceration, antacid therapy should be
begun as soon as bleeding and vomiting ceases.
Hospitalize as soon as possible. Give Cimetidine,
A hiatal hernia is caused by a portion of the
stomach passing through the hiatus.
SYMPTOMSIt is characterized by severe
heartburn, burning and pain behind the sternum,
and sensations of pressure. The pain may radiate
down the arms or into the neck and jaw.
Nocturnal regurgitation and dyspnea are
common. Lying down tends to aggravate the
symptoms, while sitting or standing relieves
TREATMENTGeneral measures include
weight reduction, antacids, and surgical correc-
tion of large hernias. Advise the patient to avoid
tight or constricting clothing, especially belts or
corsets. Further advise the patient to avoid lying
down immediately after meals and to sleep with
the head of the bed elevated.
This is an acute or chronic ulceration of the
mucous membrane in the digestive tract that is
accessible to gastric secretions. The oversecretion
of gastric acids is an important factor in peptic
ulcer formation. Psychic disturbances, such as
emotional tension, are predisposing factors.
Peptic ulcers are normally found in the first por-
tion of the duodenum or on the lesser curvature
of the stomach.
SYMPTOMSThe patient may present a
history of pain, heartburn, and abdominal
distension. Nausea, vomiting, excess salivation,
weight loss, and anorexia are common. The pain
pattern is usually stable and is often relieved by
food. Research indicates that food, no matter
what type, and even though it may relieve the
pain, tends to aggravate the condition by
causing gastric acid secretion.