Common manifestations of GI disorders Flashcards
How to categorise abdominal pain for physical assessment?
upper GI
Lower GI
Non- GI that can cause pain
common diagnosis for Upper GI
GERD ( gastroesophageal reflux disease)
Gastritis
gastric/ duodenal ulcers, biliary colic ( gall bladder stones) , pancreatitis,
maglinancy
What organs are in upper GI?
liver, oesophagus, stomach, gall bladder, pancreas, bile duct
what are the common diagnosis for lower GI?
functional bowel disorders
Inflammatory bowel diasease
diverticulosis
mechnical obstruction
maglinancy
appendicitis
what are the organs in lower GI?
large intestine, small intestine, rectum, appendix
What are the common diagnosis that are non GI related but presents with abdominal pain?
Genitourinary ( stones/ UTI, pyelonephritis)
Reproductive ( endometriosis, ovarian cysts, uterine fibroids)
Maglinancy
rare case: chest structures may promote pain in the upper abdomen which might radiate to umbilicus- belly button.
MI and pneumonia/emphyema can present this way too.
how many types of abdominal pain are there?
3
- visceral pain
-parietal pain
- referred pain
WHat is visceral pain?
- dull or achy pain
- originate in hollow organs (stomach, intestines, gallbladder, bladder, and rectum.) and capsules of solid organs
- corresponds to embryonic development
what is parietal pain?
due to stretching or irritation of parietal peritoneum
- pain is usually sharper.
what is referred pain?
- felt at a site far from diseased organ
- gallbladder pain felt from right shoulder. cholecystitis too.
what is the common condition that causes pain to radiate to the back?
pancreatitis
what is dysphagia?
difficulty swallowing
what is odynophagia
pain with swallowing
what are the types of oesophageal dysphagia?
dysphagia to solid- mechanical obstruction
dysphagia to liquids/ both liquid and solid = motility disorder or complete obstruction
how to diagnose dysphagia?
- barium swallow
- upper endoscopy
- oesophageal manometry ( monitor pressure in oesphagus as pt swallows)
- pH monitoring ( insert pH monitor)
what is associated with bird’s beak on barrium swallow?
achalasia
which electrolytes to worry about when u have diarrhea?
bicarbs and potassium. then metabolic acidosis
what are the mechanisms of diarrhea?
- osmotic ( water, lactose intolerant )
- secretory ( tumour secrete fluid into lumen of intestine)
- altered motility ( fat malabsorption, increase in colonic secretion)
- exudative diarrhea ( damage to mucosa- blood )
- anorectal dysfunction result in involuntary loss of stool, incontinence.
what causes osmotic diarrhea and describe it?
- carbohydrate maldigestion ( lactase - disaccharidase deficiency), non absorbed solutes - mannitol.
- large stool volume, osmolar gap > 100
stops with fasting.
pH<6
what causes secretory diarrhea and describe it?
- bacterial toxins ( E.coli)
- hormonal peptide eg. serotonin ( carcinoid tumour)
- excessive gastric acid’
- laxative abuse - senna
- bile salt malabsorption
- large stool volume, persistent diarrhea with fasting. osmolar gap > 50
what causes abnormal motility?
dumping syndrome
increased motility,
hyperthyroid carcinoma.
decreased motility can cause bacterial overgrowth which in turn cause diarrhea,
what causes exudative diarrhea?
inflammatory bowel disease such as ulcerative colitis, infection, diverticulitis,
ulcer and stool inside then got blood.
what does the presence of 5HIAA in the urine means
detection of carcinoid tumour
causes of primary constipation
- slow transit: prolonged stool transit through colon
- dyssynergic defecation: difficulty with expelling stool from anorectum
-irritable bowel syndrome - altered bowel habits with abdominal pain.
