Chapter 14 Gastrointestinal Evaluations and Procedures
Diseases and Disorders of the Gastrointestinal System
Digestive diseases are diverse and can encompass any organ located in the abdominal cavity. The esophagus is also included in
the digestive disease spectrum. The following table lists common diseases of the digestive tract.
Disease
Gastroesophageal
reflux disease (GERD)
(reflux of acid from
the stomach into the
esophagus)
Irritable Bowel
Syndrome (IBS)

Symptoms
Treatment
- Pyrosis (heartburn), chest pain,
nausea, and mid-epigastric
pain that improves with
antacids.
- Antacids (neutralize stomach acids, i.e., Mylanta, and
Maalox)
- Complications of GERD may
include: Esophageal ulcers or
strictures, Barrett’s esophagus
(premalignant condition), and
cancer.
- Proton pump inhibitors or PPI (decrease acid release, i.e.,
Prilosic OTC, Nexium, and Prevacid)
- Abdominal pain
- Dietary changes: Avoid foods that aggravate the condition
such as, red meats, carbonated beverages, caffeine, fatty
foods, refined carbohydrates, MSG, and lactose
- Constipation
IBS-A: Alternating
constipation and
diarrhea
- Diarrhea

IBS-C:
Constipation
predominant
- Abdominal distention

IBS-D: Diarrhea
predominant
- Bloating
- H2 Blockers (decrease acid production, i.e., Tagamet, and
Zantac)
- High fiber diet: Fiber supplements, whole wheat products,
vegetables, fruit
- Probiotic administration with acidophilus: provides
supplementation of "good" bacteria to the bowel which
regulates bowel movements and decreases gas
symptomology
- Stress management
- Complementary and Alternative medicines: Herbal
therapy, Chinese herbal therapy, acupuncture
Diverticulosis
- Usually no symptoms until the
- Increase fiber intake
Disease
(a balloon-like out
pouching of the
colonic wall)
Symptoms
Treatment
diverticuli become inflamed.
Diverticulitis
- Pain
- High fiber diet
(inflammation of the
diverticula in the
intestines)
- Anorexia
- Fiber supplements
- Fevers
- Caution with peanuts, nuts, and popcorn intake
- Peritonitis
- Mucus in stools
Peptic Ulcer Disease:
(acid related ulceration
of the stomach or
duodenal lining)
- Burning mid-epigastric pain
relieved by food, milk, and
antacids
- Nausea and vomiting
- Bloating and bleeding
- Removal of any offending medications
- Treatment of H. pylori infection
- H2 blockers
- Proton pump inhibitors
- Halitosis (bad breath)
Crohn's disease
- Abdominal pain
- Anti-inflammatory drugs
(an inflammatory
bowel disease
identified by full
thickness
inflammation)
- Weight loss
- Aminosalicylates: provide anti-inflammatory and
immunosuppressive actions and are effective for
controlling Crohn’s disease
- Diarrhea (may contain blood)
- Stools positive for occult blood
- Fever
- Inflammation in areas outside
the intestine from the mouth to
the anus
- Nutritional support
- Surgical removal of diseased segments of the bowel
- Fistulas
Ulcerative Colitis
- Bloody diarrhea
(an inflammatory
bowel disease marked
by continual
- Pain with passage of stools
- Combinations of medications, such as: Mesalamine,
Prednisone
- More than six bloody bowel
- Entocort EC (synthetic steroid)
Disease
inflammation of the
intestines)
Symptoms
movements per day
Treatment
- Immunosuppressive drugs, and Remicade (antiinflammatory drug)
- Surgery
- Alternative medicine such as Chinese herbal therapy,
acidophilus, and acupuncture
Cholelithiasis
(disease that involves
the formation of
gallstones)
- Right upper quadrant pain
following a meal
- Surgical with laparoscopic cholecystectomy (removal of
the gallbladder)
- Fatty food intolerance
- Nausea
- Right shoulder pain
Pancreatitis
- Epigastric pain
(inflammation of the
pancreas)
- Nausea
- Vomiting
- Increased serum levels of
pancreatic enzymes
Hepatitis
- Abdominal pain
(inflammation of the
liver; several different
types)
- Loss of appetite/weight loss
- Nothing by mouth until the pain, nausea, and vomiting
have subsided, and the serum levels of the pancreatic
enzymes are returning to normal
- Administration of fluids and electrolytes
- Will vary according to the type of hepatitis. Refer to
Chapter 10 for a comprehensive look at hepatitis.
- Jaundice (yellow tinge to skin)
- Fatigue
- Dark colored urine
- Nausea/vomiting
Ascites
- Swelling of the abdomen
- Paracentesis (puncture of the abdominal cavity) to remove
the fluid
- Upper abdominal pain
- Antacids
(Serous fluid
accumulation in the
peritoneal cavity)
Dyspepsia
Disease
Symptoms
(indigestion)
Treatment
- Fullness
- H2 Blockers (drugs that reduce the production of acid)
- Bloating
- Proton pump inhibitors (PPI) like Prilosec and Prevacid
- Nausea
- Loss of appetite
- Belching
- Inability to swallow
Dysphagia
- Dilatation of the esophagus to enlarge the opening
- Surgery
(difficulty swallowing)
- Medications
- Dietary changes
GI Cancers
Digestive disease cancers are varied and may be directly related to the organ or may involve metastatic disease from another
primary cancer. The following table provides of description of the various GI cancers that are commonly diagnosed and the type of
diagnostic modality that may be used to assist with diagnosis. The medical assistant may be responsible for scheduling the diagnostic
modalities listed below.
Location
Esophagus
Symptoms
Diagnostic Modality
Dysphagia, weight loss, chest pain,
hematemesis (vomiting of blood)
Esophagogastro-duodenoscopy (EGD), barium swallow, chest CT
Stomach
Midepigastric pain, nausea, vomiting,
weight loss, hematemesis, occult GI
bleeding
EGD, upper GI, abdominal CT
Small
Intestine
Vague abdominal pain, small bowel
obstruction, nausea, vomiting, weight
loss, occult GI bleeding, iron
deficiency anemia
Small bowel series, abdominal CT, capsule endoscopy
Location
Symptoms
Large
intestine
Constipation or diarrhea, weight loss,
vague abdominal pain, occult GI
bleeding, hematochezia (passing stools
that contain bright red blood), iron
deficiency anemia
Colonoscopy, barium enema, CT colonoscopy
Pancreas
Vague abdominal pain, weight loss,
jaundice (yellowish discoloration of
body tissues and fluids), back pain
Abdominal CT, abdominal ultrasound, MRI, ERCP (endoscopic
retrograde cholangio-pancreatography)
Vague RUQ pain, weight loss, jaundice
Abdominal CT, abdominal ultrasound, MRI, laparoscopy, liver biopsy
Vague RUQ pain, post-prandial pain,
weight loss, jaundice, nausea
Abdominal CT, abdominal ultrasounds, cholecystectomy
Vague RUQ pain, weight loss, jaundice
Abdominal CT, abdominal ultrasound, ERCP, MRCP (magnetic
resonance cholangio-pancreatography)
Liver
Gallbladder
Bile duct/
ampulla
Diagnostic Modality