Adult GI Flashcards
How long is the adult GI tract?
~30 feet
What are the layers of the GI tract?
mucosa, submucosa, muscle, and serosa
What are the 4 functions of the GI system?
Ingestion, Digestion, Absorption, and Elimination
Where does digestion occur?
stomach, small intestine
Where does absorption occur?
stomach, small intestines (primary)
Where does elimination occur?
colon, anus
What are different types of endoscopies?
EGD, Colonoscopy, ERCP, Video capsule
What types of radiology diagnostic tests are done for GI issues?
CT, MRI, Nuclear medicine, ultrasound
What system stimulates the GI system?
parasympathetic
What are lab values that are related to GI function?
amylase, lipase, gastrin, AST, ALT, Alk Phos, Bilirubin, Albumin, Total protein
What are 3 reasons that malnutrition may occur?
Starvation, chronic-disease related, acute disease/injury related
What are s/s of malabsorption?
weight-loss, weakness, fatigue, anorexia, hypocalciemia, bone fx, muscle weakness/tenderness, ecchymosis, anemia (pernicious from lack of B12), steatorrhea, hypoalbuminemia, reduced muscle mass (including cardiac!)
What things should be assessed when looking into a GI assessment?
Anthropometric Measurements
Physical Examination
Health History
Dietary History
Laboratory Studies
Functional Status
What are some types of enteral nutrition?
G-tube, J-tube
NG, ND, NJ
What are three things that obesity may contribute to?
DM2, CAD, and cancers
Which systems does obesity effect?
all of them
Who is affected by obesity?
all cultures, ethinicities, races, genders, ages, socioeconomic classes (the worst among the poor)
What is the most common clinical manifestation of a GI disease?
nausea/vomiting
What are some pharmacological txs for nausea/vomiting?
Anticholinergics, Antihistamines, Cannabinoids, 5-HT3 Agonists, Phenothiazines
What is the most common upper GI problem?
GERD
Where does enteral nutrition go?
Into the stomach
What are factors that affect the esophageal sphincter?
ETOH, chocolate, medications, fatty food, nicotine, peppermint, tea/coffee
What is required when parenteral nutrition is used?
bowel rest
How is GERD diagnosed?
H&P exam, EGD, Barium Swallow, mobility studies
How is GERD managed?
Identify & eliminate cause, stop eating 2 hours before bedtime, avoid acidic foods and drinks, lifestyle management, Meds (PPIs, H2 receptor blockers, antacids, prokinetic therapy), Endoscopic therapy, surgical therapy
How many hours before bed should you stop eating if you have GERD?
2
How often should blood glucose be taken when parenteral nutrition is being used?
4-6 hours
What kind of medications can be used to treat GERD?
PPIs, H2 receptor blockers, antacids, prokinetic therapy
When does TPN need to changed? And the tubing?
every 24 hours
What is a hiatal hernia?
Herniation of part of the stomach above the diaphragm
What is the most common upper GI problem found on X-ray?
hiatal hernia
What is a sliding hiatal hernia?
top of stomach slides through when patient is supine and slides back down when patient is upright
What is a paraesophageal or rolling hernia?
The fundus and greater curvature roll up through and form a pocket
What type of hernia is a medical emergency?
acute paraesophageal
What are the manifestations of a hiatal hernia?
similar to GERD
Should a patient with GERD be lying down after a meal?
no
How are hiatal hernias diagnosed?
barium swallow, EGD
What is gastritis?
inflammation of gastric mucosa
What kind of drugs are -prazoles?
PPIs
What kind of drugs are -tadines?
h2 receptor blockers
How is gastritis diagnosed?
H&P, drug and ETOH use, occ CBC and EGD
What can cause hiatal hernias?
anything that is making the abdominal cavity larger
When will someone with a gastric ulcer experience pain after eating?
1-2 hours after eating
When will someone with duodenal peptic ulcers experience pain after eating?
2-5 hours after meals
What kind of ulcers are common in women?
gastric peptic ulcers
What causes 80% of gastric peptic ulcers?
h. pylori
Are gastric peptic ulcers or duodenal peptic ulcers more common?
duodenal ulcers
What is the second most common reason for a gastric peptic ulcer?
antacid use
What is the management for gastric peptic ulcers?
Stop NSAIDS, ABX for H. pylori, ETOH & smoking cessation, eliminate coffee, Meds (H2 or PPI)
Where can pain occur with duodenal ulcers that is not seen with gastric peptic ulcers?
back
What is done to treat a hemorrhage/upper GI bleed?
EGD to cauterize bleed, meds/IVF to support pt, frequent vitals, blood products?
What are the s/s of perforation?
sudden, severe upper abdominal pain, not relieved by rest or food, no bowel tones, septic shock
Which chronic PUD complication is most lethal?
perforation
If a patient presents with pain/discomfort in the upper abdomen that worsens as the day goes on, constipation, n/v, belching, anorexia, and dehydration, what may this patient have?
gastric outlet obstruction
Why does a patient need to be NPO if there is a gastric outlet obstruction?
the bowels need to rest
What is diarrhea defined as?
3 or more loose/liquid stools per day
How can diarrhea be treated?
fluid/electrolyte support, nutrition support, antidiarrheal meds, fecal transplant for severe C-Diff
what can constipation be a symptom of?
diverticulitis or bowel obstruction
Why does constipation occur?
Too much water absorption
How is constipation treated?
increase dietary fiber & water, limit low fiber foods, limit processed foods, increase exercise & activity, beware of laxatives (dependent)
What are two types of IBD?
Crohn’s and Ulcerative Colitis
When does IBD typically occur?
at ages 15-30
What organ does ulcerative colitis involve?
colon only
Which organs does Crohn’s disease involve?
colon or small intestine
Who is at a higher risk for IBD?
white and ashkenazi jews, urban populations
What kind of bowel movements does someone with Crohn’s disease have?
Diarrhea without blood
When does Crohn’s and Ulcerative colitis typically have its onset?
teens-mid 30s and >60
Where is Crohn’s disease commonly found?
in distal ileum and colon
What layer is ulcerative colitis involved in?
mucosal layer
