Digestive System

DIAGNOSTIC TESTS FOR

DISEASES OF THE
DIGESTIVE SYSTEM
LABORATORY TESTS
CEA (Carcinoembryonic Antigen)
(+) colorectal cancer
NO heparin for 2 days
Specimen by venipuncture
The carcinoembryonic antigen (CEA) test
measures the amount of this protein that may
appear in the blood of some people who have
certain kinds of cancers, especially large
intestine (colon and rectal) cancer. It may
also be present in people with cancer of the
pancreas, breast, ovary, or lung.
CEA is normally produced during the
development of a fetus. The production
of CEA stops before birth, and it usually
is not present in the blood of healthy
adults.

Why It Is Done
The carcinoembryonic antigen (CEA) test
is used to:
Find how widespread cancer is for some
types of the disease, especially colon
cancer.
Check the success of treatment for colon
cancer.
CEA levels may be measured both before
and after surgery to evaluate both the
success of the surgery and the person's
chances of recovery.
CEA levels may be measured during
treatment with medicines to destroy cancer
cells (chemotherapy). This provides
information about how well the treatment is
working.
Check to see if cancer has returned after
treatment.
D – Xylose Absorption Test
Initial blood/urine specimen collected
NPO 10 – 12 hours
Blood/urine levels measured
For diagnosis of malabsorption

Exfoliative Cytology
Detect malignant cells
Written consent
 Liquid diet
UGI: NGT insertion
LGI: laxative; enema
Cells are obtained from saline lavage – NGT

Fecal Analysis
Stool for Occult Blood (Guaiac Stool Exam)
Detect G.I. bleeding
↑ fiber diet 48 – 72 hours
No red meats, poultry, fish, turnips, and
horseradish
3 stool specimen (3 successive days)
Withold for 48 hrs: Iron, Steroids, Indomethacin,
Colchine
 Iron causes blackish/greenish discoloration of stool
Steroids, indomethacin, colchicine may cause G.I.
irritation thereby, bleeding.

Stool for Ova and Parasites

Send fresh,warm stool specimen

Stool Culture
Sterile test tube/cotton – tipped applicator

Stool for Lipids

Assess steatorrhea
↑ fat diet, no alcohol (3 days)
72 – hours stool specimen (store on ice)
No mineral oil, neomycin SO4
Gastric Analysis
Measures secretion of HCl and pepsin
NPO for 12 hours
NGT is inserted, connected to suction
Gastric contents collected every 15 minutes to 1 hour
↑ HCl : Zollinger- Ellison Syndrome or Doudenal
Ulcer, ↓ HCl: Gastric Ca or Pernicious Anemia

Bernstein Test (Acid Perfusion Test)

To assess of chest pain is related to
gastroesophageal reflux
NPO 6 – 8 hrs
NGT insertion
Alternate instilation of NSS and 0.1% HCl
X pain (-) ; √ pain (+)
Antacid after the procedure
RADIOGRAPHIC TESTS
Scout Film/Flat Plate of the Abdomen
Plain X-ray of the abdomen
No belts/jewelries or any metal
UGIS (Upper G.I. Series/ Barium Swallow)
To visualize the esophagus, stomach, doudenum and
jejunum
NPO for 6 – 8 hours
Barium Sulfate (BaSO4) per Orem
X-rays taken on standing, lying position
After the procedure:
Laxative
Increase in fluid intake
Inform client thta the stool is white for 24 – 72 hours
Observe for Ba impaction: distended abdomen,
constipation
LGIS (Lower G.I. Series/ Ba Enema)
To visualize the colon
Low residue/clear liquid diet for 2 days
Laxative for cleansing the bowel
Suppository/cleansing enema in A.M.
BaSO4 per rectum
Care after the procedure – same as UGIS

Computed Tomography
Uses beam of radiation to assess cross sections of
the body
Clear liquid diet in A.M.
If done with contrast medium
– NPO 2 – 4 hours
– Assess history of allergy to seafoods and iodine
 Inform the client that the procedure is painless
Advise the client to remain still during the entire
procedure

ENDOSCOPY
UGI Endoscopy
Direct visualization of esophagus, stomach and
duodenum
Obtain written consent
NPO for 6 – 8 hours
Anticholinergic (At SO4) as ordered. To reduce mucus
secretions
Sedatives, narcotics, tranquilizers. To relax the client
E.g. Diazepam, Meperidine HCl
Remove dentures. To prevent airways obstruction
Local spray anesthetic on posterior pharynx – instruct: Do
not swallow saliva. To depress the gag reflex.
After the procedure
Side-lying position. To prevent aspiration
NPO until gag reflex returns (2 – 4 hours)
NSS gargle; throat lozenges. To soothe the throat.
Monitor VS
Assess: bleeding, crepitus(neck), fever, neck/throat pain,
dyspnea, dysphagia, back/shoulder pain
Advise to avoid driving for 12 hours if sedative was used.

LGI Endoscopy
Proctosigmoidoscopy (sigmoid, rectum)
Clear liquid diet 24hours before
Administer laxative as ordered
 Cleansing enema
Knee-chest/lateral position
After the procedure
– Supine position for few minutes. To prevent postural
hypotension
– Assess for signs of perforation _ bleeding, pain,
fever
– Hot sitz bath for discomfort in the anorectal area

Colonoscopy
Sedation is done
Position: left side, knee flexed
After the procedure:
– Monitor VS (note for vasovagal reponse, e.g.
bradycardia, hypotension)
– Assess for signs and symptoms of perforation
Ultrasonography
NPO for 8 – 12 hours
Laxative as ordered (↓ bowel gas)

MRI (Magnetic Resonance Imaging)

Produces cross – sectional images of organs by using
magnetic fields
NPO for 6 – 8 hours
Instruct to remain still during the procedure
Inform that procedure last for 60 – 90 minutes
Remove all metals like jewelries
Contraindications
Pacemakers
Aneurysm clips
Orthopedic screws