what is celiac disease
Condition in which intestinal villi are destroyed as part of an inflammatory reaction in the presence of gluten
AKA
� Celiac sprue
� Nontropical sprue
� Gluten-sensitive enteropathy
causes of celiac's disease
Gluten is a group of proteins in many grains
� Breaks down into gliadin
� Gliadin triggers inflammatory reaction that destroys villi in patches throughout the small intestines
� Without villi, access to all nutrients is lost
Celiac may be related to other
complications of celiac disease
In children: delayed growth, development
� Anemia, folic acid deficiency, risk of miscarriage, birth
defects in growing fetus
� Osteomalacia, osteoporosis
� CNS problems
� Behavior changes
� Irritability
� Peripheral neuropathy
� Seizures
� Risk of adenoc
signs and symptoms of celiac's disease
Related to malabsorption of nutrients
� Pain, discomfort in GI tract
� Gas, bloating, diarrhea
� High-volume stools
� Weight loss
� Anemia
� Behavioral changes, depression, irritability
� Cramps
� Weakness, poor stamina
� Several others...
� Can look like
treatment and medications for celiac disease
Short-term steroids if necessary
� Vitamin and mineral supplements as necessary
� Topical medication for dermatitis herpetiformis
avoid gluten in diet and avoid gluten in products
Massage implications of celiac disease
Risks: Watch for abdominal pain, and be sensitive to this
possibility; people with celiac may also be prone to skin
rashes that locally contraindicate massage therapy.
Benefits: A client with successfully managed celiac disease can enjoy all the benefits
what is esophageal cancer
Development of malignant cells in the esophagus
� Proximal
� Distal
Worldwide: squamous cell esophageal cancer is most common
� US: adencarcinoma of the esophagus is most common
� One of few cancers that is increasing in incidence
� 18,000 diagnoses/year
causes of esophageal cancer
Malignant cells in the upper/middle section = squamous cellcarcinoma of the esophagus
� Often related to smoking, alcohol use
Malignant cells at the distal end = glandular cancer
(adenocarcinoma)
� Often a complication of GERD, Barrett esophagus
why does metastasis occur with esophageal cancer?
No serous membrane, close contact with other organs, especially
� Trachea
� Diaphragm
� Aorta
� Vena cava
� Laryngeal nerve
� Generous lymphatic supply
� Can also spread through bloodstream
Esophageal cancer- metastasis through direct
contact can happen e
esophageal cancer signs and symptoms
Hard to find early (leads to high mortality rate)
� Dysphagia
� A sense of food getting stuck
� Pain with swallowing
� Unexplained weight loss
� Chronic cough
� Hoarseness
� Hiccups (phrenic nerve irritation)
� Other signs that suggest metastasis:
� Deep
esophageal cancer treatment
Could include...
� Surgery
� Chemotherapy
� Radiation therapy
� Photodynamic therapy (drugs that are activated by exposure to
light)
Recovery can be challenging because it is difficult to take in nutrition
Chemotherapeutic agents
� Photodynamic therapy
esophageal cancer massage implications
Risks: Make adjustments according to the client's general resilience or fragility, treatment options, and side effects or complications.
Benefits: Massage therapy has been seen to help with pain, sleep, appetite, anxiety, depression, and other challenges
What is gastroenteritis?
� Inflammation of the GI tract
� Usually stomach or small intestine
Result of infection
� Bacteria
� Virus
� Parasite
cause of gastroenteritis
Pathogens damage the intestines, lead to symptoms
� Produce toxins that damage cells
� Directly attack cells
� Exacerbated by poor motility
When GI tract is damaged, absorption of nutrients, water is impaired
� Dehydration, electrolyte loss through vomiti
pathogens that cause gastroenteritis?
Possible causes:
� Viruses- high communicable, can be epidemic
� Norwalk/noroviruses
� Rotavirus
� Hepatitis A, B, C
� Enteroviruses
Bacteria
� Salmonella
� Shigella
� Campylobacter
� E. coli
� Often food poisoning, can be other
- C-diff is especially dan
complications of gastroenteritis?
Dehydration
� Can be fatal
� Sunken eyes
� Lack of urination/dark urine
� Skin tenting
Other problems:
� Guillain-Barre syndrome
� Meningitis
� Blood poisoning
� Renal failure
signs and symptoms of gastroenteritis
Nausea
� Vomiting
� Diarrhea
Also...
� Bloating
� Cramps
� Gas
� Mucus, blood in stools