Digestive System - Pathologies Flashcards

Question

Stomach/Gastric Pathologies: What is Acute Gastritis?

Answer 1

Acute (sudden and short) inflammation of the stomach mucosa causing breakdown of the stomach lining. Insufficient mucus production means a loss of balance between stomach acid (up) and mucus (down). this creates inflammation. A blood test would show a high neutrophil count as these are the first responder white blood cells.

Answer 2

Causes: - HELICOBACTER PYLORI - Perhaps enters the stomach when stomach acid is low and embeds in the mucosal lining - NSAIDS - lower prostaglandin levels leads to reduced gastric mucosal barrier. - Alcohol, food poisoning, stress Symptoms: - EPIGASTRIC PAIN USUALLY WORSE WITH FOOD INTAKE - Nausea, vomiting, loss of appetite Treatment: Treat cause

Answer 3

Chronic stomach mucosal inflammation for more than 4-6 weeks. Whereas with acute gastritis we see a surge in neutrophils as the first responders, with chronic gastritis we LYMPHOCYTES and MACROPHAGES in THE LAMINA PROPRIA. Over time low grade inflammation can lead to fibrosis (scarring) of the stomachs mucosal lining and subsequent loss of elasticity and peristalsis

Answer 4

- ANAEMIA: megaloblastic, iron, pernicious For B12 to be absorbed in the small intestine it must first bind to Intrinsic Factor (IF) that it picks up in the stomach. IF is produced by parietal cells in the stomach. If the stomach is inflamed, parietal cells can be damaged and not able to produce IF. Less IF - less Absorption leading to megaloblastic anaemia - GASTRIC CARCINOMA Chronic inflammation increases risk of mutations in the gastric area.

Answer 5

A : AUTOIMMUNE - Associated with pernicious anaemia B: BACTERIAL - Helicobacter Pylori C: CHRONIC IRRITATION - eg: long term NSAIDS

Answer 6

Signs and Symptoms are vague. - DISCOMFORT WITH HEAVY MEALS - EPIGASTRIC DISCOMFORT - Nausea and poor appetite Treatment - Treat the underlying cause - Support immunity - Herbs such as slippery elm and aloe vera -Antimicrobial herbs is an infection - Avoid irritants

Answer 7

A Peptic Ulcer is an ulcer of the GI mucosa. It is a category that covers duodenal and gastric ulcers. It is an erosion of the superficial lining of the membrane. If the erosion is bad enough it could penetrate to the submucosa or muscularis leading to a perforation where the contents of the stomach spill out into the peritoneum. Signs and Symptoms: - Gastric: EPIGASTRIC PAIN, 30-60 MINUTES AFTER EATING, less often at night - Duodenal: EPIGASTRIC PAIN 2-3 HOURS AFTER EATING, and at night (when stomach is empty) - Pain may be amplified by irritating foods such as alcohol, coffee, spicy food, fatty/fried food - Burping, nausea

Answer 8

Causes: - 80% of cases HELICOBACTER PYLORI which wreaks havoc in the stomach - 10% of cases NSAIDS because they disrupt the mucus barrier, lower mucus production which leads to an imbalance with acid - STRESS - Sympathetic nervous system dominance can reduce blood flow and impacts on tissue repair - Chronic gastritis Treatment: Diet - avoid allergens and milk, spicy foods and bring in green veg and plenty of fibre. Cabbage Herbs - Slippery Elm, liquorice Aloe Vera, Vit A, E and zinc

Answer 9

Dumping syndrome is a group of symptoms, such as diarrhea, nausea, and feeling light-headed or tired after a meal, that are caused by rapid gastric emptying. Rapid gastric emptying is a condition in which food moves too quickly from your stomach to your duodenum. Causes: Loss of stomach effectiveness due to BARATRIC SURGERY and other GI surgeries such as gastric bypass, removal of gallbladder, gastrectomy means the stomach can't process food and so it goes into the duodenum UNDIGESTED and quickly. Because of this water is drawn into the bolus causing sudden and urgent diarrhoea. The body senses carbs are going in and releases insulin from the pancreas in preparation. However the insulin is not used so there is excess insulin . This lowers blood sugar even further leading to REACTIVE HYPOGLYCAEMIA.

Answer 10

Signs and Symptoms EARLY DUMPING straight after a meal - nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue LATE DUMPING one to three hours after a meal - weakness, sweating and dizziness due to HYPOGLYCAEMIA Treatment - can't resolve due to cause Avoid refined Crabs/sugar Separate fluids from meals smaller more frequent meals Increase dietary fibre for blood glucose control

Answer 11

2nd highest cause of cancer related death in the world. More prevalent in Asian countries and particularly Korea and Japan probably due to diet. 50% AFFECTS THE PYLORIS, 25% the lesser curvature Diagnosed through blood in stool, endoscopy and biopsy Causes/risk Factors - Male, smoking, 55 years + - HELIOBACTER PYLORI INFECTION increases risk - Diet rich in SALTED, PICKLED AND SMOKED FOODS due the Nitrates which are carcinogenic - LOW FRUIT AND VEG DIET

Answer 12

Early stages: PERSISTENT INDIGESTION, FREQUENT BURPING, heartburn, feeling full quickly, bloated, abdominal discomfort Advanced stages: BLACK BLOOD IN STOOLS, loss of appetite, weight loss, tiredness, anaemia, jaundice (because of likely spread to liver through the portal vein) Treat allopathically with surgery to remove part of stomach, chemo/radiotherapy Treat naturally - with herbs, nutritional supplements - antioxidant and nutrient rich plant based diet - alkalising the body - Homeopathy, acupuncture

Answer 13

Inflammation of the appendix which is an extension of the first part of the large intestine. Signs and symptoms: INITIALLY it shows up as UMBILICAL PAIN which is around the belly button. Within hours the pain travels to right iliac fossa (right groin) becoming constant and severe. Rebound tenderness at MCBURNEYS POINT and local muscle guarding. PALLOR, SWEATING and FEVER, NAUSEA, VOMITING, DIARRHOEA

Answer 14

Rebound tenderness on palpation over McBurneys Point* CT Scan High ESR on blood tests Hypotension * 2/3rds bertween the belly button and right pelvic bone

Answer 15

Appendectomy. SURGERY and antibiotics is usually requited for appendicities.

Answer 16

RUPTURE PERITONITIS

Answer 17

An infection of the intestines via - faeco-oral contamination of BACTERIA (Shigella) or, - AMOEBIC dysentery It is a NOTIFIABLE disease meaning it must be reported to govt authorities if you have it. It presents with - DIARRHOEA containing mucus or blood - Cramping and possibly nausea and vomiting Risk of dehydration due to diarrhoea.

Answer 18

STOOL MICROSCOPY is used to diagnose dysentery. Treatment includes: - anti-parasitic/ anti bacterial - rehydration - HERBS: antimicrobial and immune, probiotics - Colon Hydrotherapy to help eliminate amoebic cysts.

Answer 19

Small Intestinal bacterial overgrowth which is the overpopulation of microflora in the small intestines. The excessive bacterial growth can lead to production of HYDROGEN and METHANE GASES as a result of carbohydrate use. This excessive gas leads to BLOATING, FALTULENCE, BELCHING, LOSS OF APETTIE and DIARRHOEA or CONSTIPATION. Ultimately in can result in malabsorption, anaemia as well as inflammation and increases small intestine permeability.

Answer 20

ULCERATIVE COLITIS Vs CROHN'S DISEASE Region affected: Any part of the GIT but mostly the terminal ileum Vs COLON and rectum only Distribution: Skip lesions (patches) Vs continuous Layers affected: All layers (Transmural) Vs ULCERS on the mucosa only Pain Symptoms are similar: Right sides crampy abdominal pain Vs Abdominal Pain on the left Key Symptoms: Loose semi-solid tools VS bloody diarrhoea Complications: Fistula, abscesses, obstruction, malabsorption, B12 and B9 deficit Vs Haemorrhage Bowel Wall: Cobblestone appearance Vs Thin wall

Answer 21

Family history/GENETIC predisposition but not always expressed and when it is due to environmental factors DIETARY LINKS Environmental triggers - antibiotics, infections AUTOIMMUNE triggered by the above but it is not known why.

Answer 22

Diagnosis through - Inflammatory marker blood tests - ESR and CRP - Stool sample testing for Calprotectin which indicates inflammation in the stool - COLONOSCOPY and biopsy - Sigmoidoscopy Allopathic treatment is steroids and surgery Natural treatment is - diet with allergy elimination, high fibre, nutritious and anti inflammatory - probiotics, Vit A, D, E, C zinc - Homeopathy and acupunctue -

Answer 23

Symptoms of ulcerative colitis and Crohn’s disease are similar. Most occurring between 15–35 years. * Rectal bleeding. (more severe in ulcerative colitis) * Abdominal pain / cramps. * Diarrhoea (with blood, mucus). * Fever and fatigue. * Nausea / vomiting. * Delayed puberty or growth failure. * Weight loss / inability to maintain weight. * Indigestion, feel ‘blocked’. * Anaemia (fatigue, etc.).

Answer 24

A functional (where normal function is impaired) GI disorder characterised by lower abdominal discomfort and altered bowel habits . Despite this there is an ABSENCE OF ORGANIC PATHOLOGY - No structural alteration or sign of inflammation or tissue damage. Diagnosed according to ROME criteria which relate to frequency of symptoms and stools. Cause: - STRESS/EMOTIONAL FACTORS: Not the amount per se but how someone responds to it. CNS alterations in GI secretions, motility and pain sensitivity - GIT INFECTION - Food allergy or intolerance - ALTERED MICROBIOME, excessive antibiotic use

Answer 25

- ABDOMINAL PAIN AND CRAMPING THAT IS RELIEVED BY PASSING A STOOL* - Diarrhoea, constipation or alternating between the two - Bloating, painful flatulence, post prandial urgency - Incomplete emptying of bowels and mucus in the stools. * The and gut both develop from the same area of the embryo and hence share many nerve endings and neurotransmitters. For example 95% of serotonin, the so called happy hormone, is found in the digestive tract where it helps with gut motility.

Answer 26

In allopathic medicine it is with antispasmodic drugs. Naturally: - DIET: FODMAP's, non refined foods, fibre, avoid dairy and triggering foods - Probiotics - Slippery elm - peppermint - manage stress/breathing/5-HTP

Answer 27

A common AUTOIMMUNE condition where the body's immune system ATTACKS its own MUCOSA tissue in the SMALL INTESTINE in response to the ingestion of GLUTEN. Even the tiniest of quantities have this affect. 1/100th of a piece of bread. Gluten is made up two types of protein molecules: GLIADINS and GLUTENINS. Gliadin is modified by an enzyme called TISSUE TRANSGLUTAMINASE (tTG) and this modification means it is presented to the immune system for inspection. In coeliac the immune system mistakenly identifies these proteins as foreign and starts to attack the lining of the small intestine where the gluten is being absorbed. The immune system PRODUCES ANTIBODIES and an inflammatory immune reaction and this STRIPS THE MICROVILLI and VILLI causing atrophy and resulting in A LOSS OF ABSORPTIVE SURFACE AREA. Gluten is found in wheat, spelt, rye and barley. Affects 1 in 100 people but only 10-20% are diagnosed. Genetic susceptibility. HLA-DQ2 and DQ8 increase risk of the disease being expressed. Complications: - Can lead to osteoporosis and aneamia due to malabsorption - Bowel cancer

Answer 28

Genetic susceptibility. HLA-DQ2 and HLA-DQ8 increase risk of the disease being expressed.

Answer 29

There are classic GI symptoms such as: chronic diarrhoea/constipation, pale foul smelling stools, fatty stools, bloating, flatulence, abdominal pain, loss of appetite, weight loss, lactose intolerance due to loss of brush border enzymes Extra symptoms not typically associated with GIT: - Lethargy, fatigue (iron deficiency anaemia) and irritability - delayed growth in childhood - mouth ulcers - neurological problems (anxiety and depression) - Dermatitis Herpeiformis (blistering rash) - muscle/jointpain - Osteopenia/osteoporisis due to calcium absorption - infertlity

Answer 30

Diagnosis: - Blood test for ANTI-TRANSGLUTAMINASE ANTIBODIES - Endoscopy with biopsy of the small intestinal mucosa - only way to get a definite diagnosis - Stool test Treatment - GLUTEN FREE DIET - no wheat, spelt, rye or barley - avoid cross pollination with gluten sources when selecting, storing or preparing food

Answer 31

Diverticulosis is the presence of pea sized pouches in the wall of the digestive tube. They are caused by herniations of mucosa bulging out of the colon wall and usually due to CONSTIPATION/straining from a LOW FIBRE DIET and leading to intra-abdominal pressure. It is mostly asymptomatic but 15-25% of people with it will go on to develop ... Diverticulitis is a complication of Diverticulosis when food and faeces is trapped in the pea sized colon pouches and become INFECTED and INFLAMED (and bleed).

Answer 32

Signs and Symptoms: BLOATING, ABDOMINAL PAIN, DIARRHOEA. Fever, chilld Allopathic treatment through antibiotics and occasionally surgery Treatment through DIET: high fibre, avoid small seeds that can get stuck, slippery elm, Vit A,D,E=, Zinc, omega-3, homeopathy, herbs, acupuncture

Answer 33

When an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall. We get an organ coming through the gap.

Answer 34

INGUINAL Hernia: Commonly affects men and shows up as SWELLING OR LUMP IN THE GROIN. Often appears after straining and because of INCREASE IN INTRA-ABDOMINAL PRESSURE. It is serious when the bowel rotates on itself and strangulates itself leading to loss of oxygen and death of tissue. HIATUS Hernia is where a portion of the STOMACH PROTRUDES INTO THE THORACIC CAVITY through an opening in the diaphragm. Rarely symptomatic but can cause GORD. INCISIONAL Hernia following a surgical procedure.

Answer 35

Pain may be more noticeable with strain Pain disappears when lying down If no strangulation occurs, Hernia's often resolve themselves but if there is strangulation, surgery is required.

Answer 36

Benign epithelial growths of colonic mucosa that are diagnosed with a colonoscopy. They are usually asymptomatic with blood hidden in the stool. In less than 1% of polyps they can become malignant. Therefore when found they are usually removed.

Answer 37

A malignant tumour that rarely shows symptoms until late in the day and therefore commonly metastasises. Often this is to the liver because of the portal vein link taking blood from digestive processes to the liver. Eventual symptoms can be FLUCTUATING BOWEL HABITS (CONSTIPATION AND DIARRHOEA) and BLOOD AND MUCUS IN STOOLS. Also ABDOMINAL PAIN.

Answer 38

Strong link with a diet high in meat, low fibre, lack of Vit D, polyps, family history

Answer 39

- Colonoscopy and biopsy - Stool analysis looking for occult (hidden) blood and elevated M2PK - Blood test for inflammatory markers and especially CEA, low Hb

Answer 40

Acute inflammation of the pancreas caused by enzymes (proteases) being ACTIVATED whilst still in the pancreas (rather than after they are released from the pancreas) leading to self digestion of pancreatic tissue. The causes of this tend to be alcohol abuse, gall stones or cancer

Answer 41

SUDDEN EXTREME PERIUMBILICAL PAIN Nausea, vomiting, diarrhoea, fever. Mild cases improve in a week

Answer 42

Because the pancreas is activating all of these enzymes they are flooding out in the blood and can be detected. Can be 3 x normal level in a blood test. Increased blood glucose

Answer 43

Chronic inflammation of the pancreas that leads to permanent tissue damage (FIBROSIS and cysts) and obstruction of the common bile duct (and therefore the outflow of bile and pancreatic juices) with calcified secretions. In 60% of cases it is caused by long term alcohol abuse. Other causes are autoimmune pancreatitis, pancreatic dusct obstruction, complication of cystic fibrosis or it is idiopathic.

Answer 44

Repeated episodes of ABDOMINAL PAIN FATTY, FOUL SMELLING STOOLS because bile is not removed by the common bile duct and therefore not absorbed so it exits through the stools. It can lead DIABETES MELLITUS

Answer 45

Poor prognosis - typically less than 6 months - due to vague symptoms - APPROX 60% METATSTATIC AT DIAGNIOSIS Most arise from exocrine cells (release hormones in to a gland) Less commonly from ENDOCRINE ISLET CELLS. (produces hormones (e.g., insulin and glucagon) that are secreted into the bloodstream.)

Answer 46

1. EPIGASTRIC PAIN radiating to the back Unexplained WEIGHT LOSS, anorexia and fatigue 2. JAUNDICE - due to obstruction of the bile duct and bilirubin build up as a result or secondary liver cancer 3. Post prandial nausea 4. Glucose intolerance(if neuroendocrine tumours))

Answer 47

Irreversible scaring of liver tissue due to long term damage. The scar tissue - renders the liver cell (hepatocyte) FIBROTIC NON FUNCTIONAL meaning it can't do what it is meant to do. Function is impared - It also disrupts hapatic blood flow and bile flow leading to PORTAL HYPERTENSION because if the liver is blocked the blood can flow backwards into the poratl vein. Causes: ALCOHOLIC LIVER DISEASE HEPATITIS B/C In rarer instances - bile obstruction; autoimmune liver disease; long term exposure to toxins

Answer 48

80-90% destruction of functional liver tissue

Answer 49

The opposite of what a functioning liver looks like: REDUCED ability to synthesise substances such as clotting factors DECREASED removal and conjugation of bilirubin IMPAIRED nutrient absorption IMPAIRED glucose metabolism DECREASED inactivation of hormones DECREASED removal of toxic subtances

Answer 50

Blood tests: RAISED LIVER ENZYMES, paricularly ALT and AST. ULTRASOUND, BIOPSY Allopathically a liver transplant Natural support: The liver is regenerative but the more severe and advanced the disease the harder regenration is Diet - highly nutritious, alkalising, plant based, oxidant rich, low salt (reduce oedema), avoid toxins such as alcohol and cafiene Lose weight, exercise Good hygiene Hoemopathy, herbs and acupuncture

Answer 51

Liver cancer can be PRIMARY or SECONDARY. Primary usually coexists with liver cirrhosis and more commonly affects men at a peak age of 60. Secondary has spread from another tissue, commonly stomach or colon due to the poratl vein carrying blood between these organs. Signs and Symptoms: - In the advanced stages: JAUNDICE; ASCITES (fluid in the paritoneum), HEPATOMEGALY (enlarged liver) - PRURITUS (itchy skin); BLEEDING OESOPHAGEAL VARICES (enlarged veins); WEIGHT LOSS - Vomiting, loss of appetite, feelign very full after eating, feeling sick, pain or swelling in the abdomen, fatigue and weakness)

Answer 52

Causes: - LIVER CIRRHOSIS: Alcohol, toxins > necrosis > chronic inflammation and cell proliferation (turnover) - HEPATITID B/C: Viral integration in to host genome affecting DNA Natural Support: Herbs, nutritional supplements - diet, alkalising body. Homeopathy, herbs, acupuncture

Answer 53

Gallstones are one or more stones in the gallbladder. The stones are comprised of cholesterol. The gallbladder is the role of exit for any excess cholesterol the body is accumulating. Signs and Symptoms: In developed countries 10-20% of adults and 20% of people over 65 years have gallstones but 70% are asymptomatic at diagnosis. - Bilary Colic (pain radiating under the right shoulder mostly at 1-2 am) - ABDOMINAL PAIN/SHOULDER PAIN (Tip of right shoulder - referrred pain from the irritated diaghram)) - Jaundice, fever, bloating, nausea - Floating fatty stools

Answer 54

5 F's - FAT, FORTY, FEMALE, FAIR, FERTILE

Answer 55

DIET - increase fibre, reduce fats, etc Peppermint - dissolves them

Answer 56

Otherwise known as pinworm. It is a parasitic HELMINTH infection with a life span of around 2 months. Eggs are ingested through a FAECO-ORAL ROUTE and hatch in the duodenum within 6 hours. Worms mature in 2 weeks and commonly inhabit the ileum and large intestine. Female works MIGRATE TO THE RECTUM and of not expelled move to the anus to deposit eggs. Once in a household it is very very easy to spread through furniture, towels etc very common in CHILDREN UNDER 10

Answer 57

Can be asymptomatic INTENSE ITCHING AROUND THE ANUS or vagina particularly at night. Allopathically anti-parasitic drugs Naturally - anti worm herbs such as oregano oil and garlic oil added topically or ingested

Answer 58

It is an intracellular (inside the cell) protozoa parasite There are four microorganisms: 1. Bacteria 2. Viruses 3. Fungus 4. Protozoa It can get into the brain in some instances. We know this because rodents who have it lose their fear of cats and are in fact attracted to them. It manipulates the rodents brain to ensure it is passed on to cats. It can only reproduce in the intestines of CATS.

Answer 59

Causes: UNDER-COOKED MEATS, poor food hygiene, handling CAT LITTER TRAYS, IMMUNOCOMPROMISED. Signs and Symptoms: -Many CARRIERS ARE ASSYMPTOMATIC because the immune system contains the illness. They carry the parasite as CYSTS -MILD FLU LIKE SYMPTOMS - In PREGNANCY THERE ARE HEALTH RISKS - miscarriage and stillborns - Because if the brain access it can cause encephalitis and schizophrenia

Answer 60

9 quadrants - need to explore this!!!