TREATMENT—The 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 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.
TREATMENT—In 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.
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.
SYMPTOMS—The 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 upset.
TREATMENT—The patient should be instructed about personal and living habits and hygiene. Emphasize adequate and regular sleep, nourishing meals, and exercise. Treat symptomatically.
This is rather a common medical emergency. It results from such conditions as peptic ulcer perforation, gastritis, and esophageal varices.
SYMPTOMS—The 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 hypovolemic shock.
TREATMENT—General 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, IV therapy.
A hiatal hernia is caused by a portion of the stomach passing through the hiatus.
SYMPTOMS—It 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 them.
TREATMENT—General measures include weight reduction, antacids, and surgical correction 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 portion of the duodenum or on the lesser curvature of the stomach.
SYMPTOMS—The 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.