Disorders of the Gastrointestinal System, 2nd Edition
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swollen, and blood flow decreases, caus - ing ischemia (Kapoor, 2022). EVIDENCE-BASED PRACTICE ALERT Recent research has indicated that ob- structions caused by gallstones may not cause cholecystitis when present alone. These studies showed that an additional source of irritation must also be present, but further research is needed (Zakko & Afdhal, 2022). Figure 8. Gallstones
| NURSING CONSIDERATION
Pancreatic enzymes can be elevated for reasons unrelated to pancreatitis, so this criterion should not be used alone to diagnose pancreatitis de- finitively. Other conditions that can cause elevated pancreatic enzymes to include intestinal obstruction, ovarian disease, renal problems, and mesen- teric ischemia (Tang, 2021). Prevention of pancreatitis focuses on removing the root cause (Tang, 2021). For example, if it develops from alcohol abuse, nursing care should focus on pro- viding the best environment possible to detoxify and support the patient through potential withdrawal and cessation. An- other potential cause is a gallstone, which may necessitate removing the gallstone to treat and prevent recurrent pancreati- tis. Ongoing monitoring by the patient’s healthcare team will be necessary to en- sure appropriate education and treatment are available to support these prevention efforts (Tang, 2021). Cholecystitis The gallbladder is located in the gas- trointestinal system, just below the liver. Its stores and secretes bile made by the liver, which aids in digestion and break- ing down fats. A blockage of the cystic duct often causes gallbladder inflamma - tion, resulting in cholecystitis. Most of - ten, the blockage is related to gallstones. Around one-third of those with gallstones will develop acute cholecystitis (Kapoor, 2022). Gallstones are typically formed by a buildup of cholesterol, bile, or bilirubin that hardens (Jones et al., 2022). Once a gallstone is lodged in the cystic duct, the gallbladder becomes distended and
Note . Chernilevsky., G. (2015). Gallstones. https://com- mons.wikimedia.org/wiki/File:Human_gallstones_2015_ G1.jpg. CC BY-SA 4.0. As noted above, most cholecystitis di- agnoses are related to the formation of gallstones; therefore, those at the highest risk of developing gallstones are also at a higher risk of developing cholecystitis. Risk factors for developing gallstones in- clude (Jones et al., 2022): ● Scandinavian, Hispanic, or Pima Indian heritage (Kapoor, 2022). ● Older age. ● Obesity or rapid weight loss. ● Family history of developing gallstones. ● Chronic illness (e.g., diabetes). ● Low-fiber, high-fat, high-sugar diet. ● Female sex.
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