GASTROINTESTI

NAL

SYSTEM
Marlo D. Norbe
BSN2A
 OVERVIEW
• The gastrointestinal tract (GIT) consists of a
hollow muscular tube starting from the oral
cavity, where food enters the mouth, continuing
through the pharynx, esophagus, stomach and
intestines to the rectum and anus, where food is
expelled.
• There are various accessory organs that assist the
tract by secreting enzymes to help break down
food into its component nutrients. Thus the
salivary glands, liver, pancreas and gall bladder
have important functions in the digestive system.
Food is propelled along the length of the GIT by
peristaltic movements of the muscular walls.
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 OVERVIEW
The primary purpose of the gastrointestinal tract is to break
food down into nutrients, which can be absorbed into the
body to provide energy. First food must be ingested into the
mouth to be mechanically processed and moistened.
Secondly, digestion occurs mainly in the stomach and small
intestine where proteins, fats and carbohydrates are
chemically broken down into their basic building blocks.
Smaller molecules are then absorbed across the epithelium of
the small intestine and subsequently enter the circulation.
The large intestine plays a key role in reabsorbing excess
water. Finally, undigested material and secreted waste
products are excreted from the body via defecation (passing
of feces).

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 OVERVIEW
• In the case of gastrointestinal disease or disorders, these
functions of the gastrointestinal tract are not achieved
successfully. Patients may develop symptoms of nausea,
vomiting, diarrhea, malabsorption, constipation or
obstruction. Gastrointestinal problems are very common
and most people will have experienced some of the
above symptoms several times throughout their lives.

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 Structures
1 and
Functions
“

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Basic Structures
• The gastrointestinal tract is a muscular
tube lined by a special layer of cells,
called epithelium. The contents of the
tube are considered external to the
body and are in continuity with the
outside world at the mouth and the
anus. Although each section of the tract
has specialized functions, the entire
tract has a similar basic structurewith
regional variations.

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The Wall is Devided into
Foue Layers
1. Mucosa
2. Submucosa
3. Muscularis Externa
4. Serosa / Mesentery

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Individual Components Of
the Gastrointestinal System
• Oral cavity
The oral cavity or mouth is responsible for the intake of food.
• Salivary glands
Three pairs of salivary glands communicate with the oral cavity.
(Parotids, Submandibular, Sublingual)
• Esophagus
The tube that allows the passage of the food bolus from the
mouth to the stomach.
• Stomach
Functions to store, churn, and puree food into a substance known
as chime.

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Small intestine
Composed of the duodenum, jejunum, and ileum. The primary function of the small
intestine is the absorption of vitamins and nutrients, including electrolytes, iron,
carbohydrates, proteins, and fats.
Large intestine
Its major functions are to dry out the indigestible food residue by absorbing water and to
eliminate these residues from the body as feces. Food that being passed through the colon
is too quickly when a person is having a diarrhea that results to loose or watery stool.
Liver
The liver has several important functions. It acts as a mechanical filter by filtering blood
that travels from the intestinal system. It detoxifies several metabolites including the
breakdown of bilirubin and estrogen. In addition, the liver has synthetic functions,
producing albumin and blood clotting factors. However, its main roles in digestion are in
the production of bile and metabolism of nutrients.

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• Gall bladder
The main functions of the gall bladder are storage and concentration of bile.
• Pancreas
The pancreas has both exocrine and endocrine functions.
• Anus
The opening where the gastrointestinal tract ends and exits the body. It starts at
the bottom of the rectum, the last portion of the colon (large intestine).

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ASSESSMEN
T
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Assessment will include inspection,
auscultation and light palpation of the
abdomen to identify visible
abnormalities;
bowel sounds and softness/tenderness.
Ensure stomach is not full at time of
assessment as this may induce
vomiting.

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 History
- Feeding (type of feed/patterns / difficulties) e.g.
TPN, formula feeds, breastfeeding , any allergies /
intolerances of feed
- Elimination (frequency, consistency, colour, any
bleeding)
- Pain, cramping, nausea, vomiting (frequency,
colour, bleeding, consistency)
- Previous GI interventions /concerns such as stoma,
bowel obstruction etc.
- Previous NGT/NJT/PEG/PEJ

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 Inspection
• Shape /symmetry of the abdomen (flat, rounded, distended,
scaphoid)
• Contour of the abdomen(Smooth, lesions, malformations, any
old or new scars)
• Distention (mild / moderate / severe – tight / shiny)
• Umbilicus (bulging, scars, piercings) In neonates observe for
redness, inflammation, discharge, presence of cord stump
• Inguinal area (bulging, herniation)
• Visible peristalsis
• Presence of NG / NGT / PEG/PEJ (indication)
• Stoma site (dressing regimen / frequency and consistency of
output)
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 Palpation
• Light palpation only to identify
• Tenderness
• Distention (soft, firm)
• Pain (location, characteristics)

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 Auscultation
 Four quadrants (RUQ, RLQ, LUQ, LLQ) for
bowel motility
 Bowel sounds present (frequency / character)
 Absent bowel sounds (one or all quadrants)
 Abdominal girth measurement as clinically
indicated

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Laboratory Tests
and
Diagnostic
Procedure
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• Blood test
• Urine tests
• Stool culture
• Fecal occult blood test
• Upper gastrointestinal study (upper GI series, UGI)
• Tube gastric analysis
• Esophagogastroduodenoscopy (EGD, UGI endoscopy, gastroscopy)
• Capsule endoscopy

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• Barium swallow and gastrografin studies
• Esophageal function studies (bernstein test)
• Sigmoidoscopy (lower GI endoscopy)
• Upper GI endoscopy
• Barium enema study (lower GI series)
• Colonoscopy

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NURSING
IMPLICATION

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• 1. Assess stool characteristics.
• 2. Assess for vomiting.
• 3. Assess for presence of illness.
• 4. do Physical examination.
• 5. Reduce infection transmission.
• 6. Promote skin integrity.
• 7. Prevent dehydration.
• 8. Maintain adequate nutrition.
• 9. Maintain body temperature.
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 THANK YOU
and
 KEEP SAFE