Chapter 34

Assessment of Digestive and

Gastrointestinal Function

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Functions of the Digestive Tract

• Breakdown of food for digestion

• Absorption of nutrients produced by digestion into the
bloodstream
• Elimination of undigested foodstuffs and other waste
products

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Terms

Digestion: phase of the digestive process that occurs

when enzymes mix with ingested food and when
proteins, fats, and sugars are broken down into their
component molecules
Absorption: phase of the digestive process that occurs
when small molecules, vitamins, and minerals pass
through the walls of the small and large intestine and
into the bloodstream
Elimination: phase of the digestive process that occurs
after digestion and absorption, when waste products are
eliminated from the body

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Organs of the Digestive System

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Major Enzymes and Secretions

• Mouth: saliva, salivary amylase

• Stomach: hydrochloric acid, pepsin, intrinsic factor
• Small intestine: amylase, lipase, trypsin, bile
• See Table 34-1

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question

The enzyme bile that is responsible for fat emulsification is

secreted by which of the following?
a. Small intestine
b. Gallbladder
c. Stomach
d. Mouth

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer

b. Gallbladder
Rationale: Bile is secreted by the liver and gallbladder.

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question

Tell whether the following statement is true or false.

Blood flow to the GI tract is about 20% of the total cardiac
output.

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer

True.
Rationale: Blood flow to the GI tract is about 20% of the
total cardiac output and increases significantly after
eating.

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Assessment: History

• Include all information related to GI function

– Abdominal pain, dyspepsia, gas, nausea and
vomiting, constipation, diarrhea, fecal continence,
change in bowel patterns, characteristics of stool,
jaundice, history of GI surgery or problems, appetite
and eating patterns, teeth, and nutritional
assessment, including weight patterns
• Psychosocial, spiritual, and cultural factors
• Assess knowledge; need for patient education

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Common Sites of Referred Abdominal Pain

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Examination of the Abdomen

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Quadrants of the Abdomen

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Diagnostic Tests
• Stool specimens
• Breath tests
• Abdominal ultrasound
• Imaging studies: CT, PET, MRI
• Upper GI tract study
• Lower GI tract study
• GI motility studies
• Endoscopic procedures
• Other
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Gastroscopy

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Colonoscopy

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Sigmoidoscopy

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question

Which of the following would not be considered a

consequence of diarrhea?
a. Bicarbonate loss
b. pH of 7.30
c. Electrolyte imbalance
d. Hyperkalemia

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer

d. Hyperkalemia
Rationale: A complication of diarrhea is a decreased
potassium level (hypokalemia).

Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins