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  • Image not available. The patient history is key to evaluating gastrointestinal (GI) tract disorders and should include the problem onset, the setting in which it developed, and its presentation. Patient warning signs and alarm symptoms should be identified quickly and referral for further evaluation should be obtained in a prompt manner.
  • Image not available. A complete physical examination should be performed, the severity and location of symptoms directing the focus of the examination.
  • Image not available. Contrast agents barium sulfate and gastrograffin allow evaluation of the hollow organs of the digestive tract for mucosally-based lesions as well as narrowing or strictures involving the GI tract.
  • Image not available. The upper GI series involves radiographic visualization of the esophagus, stomach, and small intestine; whereas the lower GI series involves visualization of the colon and rectum.
  • Image not available. Enteroclysis is used to evaluate the small bowel by introducing contrast agents by tube through the nose or mouth directly into the small intestine.
  • Image not available. Trans-abdominal ultrasound, computed tomography, and magnetic resonance imaging provide images of the gallbladder, liver, pancreas, and abdominal wall.
  • Image not available. Radionuclide imaging is sometimes useful to visualize and evaluate the liver, spleen, bile ducts, and gallbladder.
  • Image not available. The endoscope, an illuminated optical instrument, remains the cornerstone of gastrointestinal diagnosis and most importantly therapy. Common examples of endoscopic procedures include esophagastroduodenoscopy, colonoscopy, enteroscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound.
  • Image not available. Capsule endoscopy, a newer less invasive endoscopic technique, takes pictures of the GI tract in the assessment of the small bowel in particular.
  • Image not available. Ambulatory esophageal pH measurement is an important diagnostic test for gastroesophageal reflux disease and is often performed in conjunction with upper endoscopy. Most systems today are completely wireless and patient friendly.
  • Image not available. Multichannel intraluminal impedance and pH monitoring combines acid exposure with impedance changes in resistant flow to aid the diagnosis of reflux in patients receiving a proton pump inhibitor and other antisecretory medications.

Upon completion of the chapter, the reader will be able to:

  • 1. Recognize gastrointestinal warning signs and symptoms.
  • 2. List the components of a patient history as it relates to the gastrointestinal (GI) tract.
  • 3. List pertinent questions that should be included in a comprehensive GI patient history.
  • 4. Determine from a medication history, which agents are associated with GI injury.
  • 5. Assess various laboratory tests for their role in assessment of GI organ function, screening of GI disorders, and evaluation of the effectiveness of therapy.
  • 6. Determine the usefulness of microbiologic test in the evaluation of unexplained diarrhea, abdominal pain, and suspected GI infections.
  • 7. Describe the usefulness of radiologic procedures in the evaluation and interpretation of GI disorders.
  • 8. Compare barium sulfate and gastrograffin contrast agents in the study of the GI tract.
  • 9. Describe general preparation of the GI tract prior to a lower GI series or sigmoidoscopy.
  • 10. List advantages of imaging studies of the GI tract.
  • 11. List anatomical areas that can be visualized by endoscopy.
  • 12. Describe the similarities and differences between endoscopy and capsule endoscopy.
  • 13. Determine the gold standard test for evaluation of patients with complaints ...

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