will suffer pain, nausea, and vomiting. Strangulation (the intestinal loop becomes twisted or severely pinched and the blood supply is cut off) results in perforation and peritonitis.
TREATMENT—For a reducible hernia, these measures include bed rest, Trendelenburg’s position, and moist heat. For incarcerated and strangulated hernias, do not exert any pressure on the mass at any time. Opiates may be administered for pain. If perforation and peritonitis have resulted, administer IV and antibiotic therapy. Medically evacuate the patient as soon as possible for surgical care.
This is an inflammatory disease of the colon of unknown etiology characterized by bloody diarrhea and prostration. The patient may experience 30 to 40 bowel movements per day. Abdominal cramping, anorexia, malaise, and fever are common.
TREATMENT—General measures consist of bed rest, nutritious diet with no dairy products, mild sedation, and steroids.
They are varices of the three hemorrhoid veins. Hemorrhoids are usually mild and remittent. The patient complains of pruritus, incontinence, and recurrent protrusion, rectal bleeding, and sensation of discomfort and pain.
TREATMENT-General measures consist of a low roughage diet, regular bowel habits, sitz baths, suppositories, and surgical treatment, if necessary.
This condition is the result of an inflammation of the liver. There are two types of viral hepatitis: hepatitis A (infectious) and hepatitis B (serum). A third type of hepatitis is alcoholic hepatitis, which is induced only by alcoholic ingestion. Hepatitis A is usually transmitted by the fecal-oral route and occurs sporadically or in epidemics. Hepatitis B is transmitted by inoculations of infected blood in most cases, but may be transmitted by the common use of razors, toothbrushes, and drug paraphernalia.
SYMPTOMS—They include general malaise, myalgia, symptoms of URI, anorexia, distaste for smoking, nausea, vomiting, fever, dark urine, and an enlarged tender liver. Jaundice mayor may not be present.
TREATMENT—Strict isolation is not necessary, but careful hand washing techniques are essential. Bed rest should be at the patient’s option during the acute initial phase of the symptoms but is unwarranted thereafter. A gradual return to normal activity and a high protein diet is indicated.
This condition is an acute inflammation of the gallbladder, usually associated with gallstones (cholelithiasis). It occurs when calculus becomes impacted in the cystic duct and inflammation develops behind the obstruction.
SYMPTOMS—Attacks are often precipitated by a large fatty meal. The appearance is sudden and pain may vary from minimal to severe. Pain is localized in the epigastrium or right hypochondrium, but may be referred to the midscapular or intrascapular regions. The right upper quadrant is tender with muscle guarding and rebound tenderness. The gallbladder is palpable and jaundice may be present due to blockage of the common bile duct. There is usually some nausea, vomiting, and fever.
TREATMENT—Treat with analgesics, IV therapy, and antibiotics as necessary. Diet should be low fat as tolerated. With the above conservative regimen, mild acute attacks will usually subside; however, reoccurrences are common and cholecystectomy may be necessary. Complications include perforation, peritonitis, and abscess. NOTE: Cholelithiasis requires surgery and is more common in women.
It is a severe abdominal disease for which causes have not been completely determined. About 40 percent of the cases are alcoholics; 40 percent have associated biliary tract disease, usually with gallstones; and the remaining 20 percent have a variety of causes.
SYMPTOMS—Onset is sudden with steady, severe pain located in the epigastrium that may