HCA 205 Module 5 Common Digestive Diseases Example

From Heartburn to Screening: A Survey of Common Digestive Diseases

Student Name

Health Care Administration Program, Aspen University

HCA 205: Principles of Health and Disease

Instructor Name

Month Day, Year

From Heartburn to Screening: A Survey of Common Digestive Diseases

The digestive system runs from the mouth to the rectum and includes the liver, gallbladder and pancreas. Its diseases are among the most common reasons people seek care and among the most costly to treat. In 2018, gastrointestinal health care spending in the United States totaled $119.6 billion, with more than 36.8 million outpatient visits for digestive symptoms (Peery et al., 2022). This paper surveys five common digestive diseases and follows two composite patients.

Two Composite Patients

Mr. A., a composite 50-year-old bus driver, has woken with heartburn on most nights for the past year and chews antacids daily. Ms. J., a composite 46-year-old accountant, feels well but has never had colon cancer screening; her uncle had colon cancer at 58. Neither has seen a clinician about these issues in over two years, a common pattern for adults who feel mostly well.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease occurs when stomach acid flows back into the esophagus, causing heartburn and regurgitation. Risk factors include excess weight, large or late meals, smoking and hiatal hernia. Reflux is common; a systematic review estimated prevalence of 18.1% to 27.8% in North America and found evidence that it had increased since the mid-1990s (El-Serag et al., 2014). Diagnosis is usually based on symptoms and response to treatment.

Treating Reflux

Treatment begins with weight loss if needed, avoiding meals within three hours of bed, raising the head of the bed and limiting triggers such as alcohol and fatty foods. Acid-reducing medicines, especially proton pump inhibitors, relieve symptoms for most people. Warning signs such as trouble swallowing, weight loss, vomiting blood or black stools call for endoscopy. Mr. A.'s daily symptoms for a year justify a visit and a trial of treatment, and long-standing reflux may warrant endoscopy to check for changes in the esophagus.

Peptic Ulcer Disease

Peptic ulcers are sores in the lining of the stomach or first part of the small intestine. Most are caused by infection with the bacterium Helicobacter pylori or by regular use of nonsteroidal anti-inflammatory drugs such as ibuprofen. Symptoms include burning upper abdominal pain, and complications include bleeding. Testing for H. pylori and treating it with antibiotics cures most infection-related ulcers. Older adults who take pain relievers daily for arthritis are at particular risk and may need a stomach-protecting medicine.

Inflammatory Bowel Disease

Inflammatory bowel disease includes Crohn disease, which may involve the tract anywhere from mouth to anus, and ulcerative colitis, which affects the colon. Both are chronic immune conditions causing diarrhea, abdominal pain, weight loss and sometimes bleeding, usually starting in young adulthood. Colonoscopy with biopsy confirms the diagnosis. Treatment uses medicines that reduce inflammation or suppress the immune response, and some patients need surgery.

Fatty Liver Disease

Fat buildup in the liver linked to obesity, diabetes and high cholesterol is now one of the most common liver conditions. It often causes no symptoms and is found through blood tests or imaging. Over years, it can progress to inflammation, scarring and cirrhosis. Weight loss is the main treatment.

Colorectal Cancer

Colorectal cancer usually develops from polyps over many years, which is why screening works: removing polyps prevents cancer, and finding cancer early improves survival. Current national guidance starts screening at 45 and continues to 75, a change from the earlier start at 50 made partly because incidence in adults aged 40 to 49 rose by almost 15% between 2000-2002 and 2014-2016 (US Preventive Services Task Force, 2021). Options include colonoscopy every 10 years and stool-based tests at shorter intervals.

Comparison

The table compares the five diseases.

Ms. J.'s Screening

Ms. J. is 46, so she is due for screening. Her uncle's cancer, a second-degree relative, does not usually change the starting age the way a parent's or sibling's cancer would, but it is worth recording. She chose a stool-based test she could do at home, with the understanding that a positive result would require colonoscopy.

What a Practice Can Do

Practices can raise screening rates by flagging patients aged 45 to 75 who are due, mailing stool test kits with clear instructions, tracking returned kits and making sure every positive result leads to a scheduled colonoscopy. For reflux, clinics can review long-term proton pump inhibitor use and reduce doses when possible. For fatty liver disease, weight management programs address the root cause.

Liver Disease and Alcohol

Alcohol is another major cause of liver disease. Heavy drinking over years causes fatty liver, then alcoholic hepatitis and cirrhosis. Viral hepatitis B and C also damage the liver; hepatitis C can now be cured with oral medicines, and hepatitis B can be prevented by vaccination. Practices can screen adults once for hepatitis C, ask about alcohol use at every yearly visit and vaccinate against hepatitis B.

When to Worry

Most digestive symptoms are minor, but some signal serious disease. Warning signs include unintended weight loss, difficulty swallowing, persistent vomiting, blood in the stool or black stools, anemia and new symptoms after age 50. Front desk and nursing staff who take phone calls should know these signs so that patients who report them are seen promptly rather than scheduled weeks out.

The Administrator's View

For administrators, digestive disease means managing endoscopy access, prior authorizations for colonoscopy and costly medicines for inflammatory bowel disease, and quality measures tied to colorectal cancer screening rates. Many payers and quality programs track the share of eligible patients who are up to date with screening, so improving screening supports both patient health and practice performance.

Conclusion

Digestive diseases range from common, usually mild reflux to life-threatening cancer. Reflux and ulcers respond well to treatment of their causes, inflammatory bowel disease requires long-term care, fatty liver disease reflects the same risk factors as diabetes and heart disease, and colorectal cancer is largely preventable through screening. Mr. A. and Ms. J. show two sides of digestive care: treating symptoms and finding disease before symptoms appear.

References

El-Serag, H. B., Sweet, S., Winchester, C. C., & Dent, J. (2014). Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review. Gut, 63(6), 871-880. https://doi.org/10.1136/gutjnl-2012-304269

Peery, A. F., Crockett, S. D., Murphy, C. C., Jensen, E. T., Kim, H. P., Egberg, M. D., Lund, J. L., Moon, A. M., Pate, V., Barnes, E. L., Schlusser, C. L., Baron, T. H., Shaheen, N. J., & Sandler, R. S. (2022). Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2021. Gastroenterology, 162(2), 621-644. https://doi.org/10.1053/j.gastro.2021.10.017

US Preventive Services Task Force. (2021). Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(19), 1965-1977. https://doi.org/10.1001/jama.2021.6238