Diseases Of The Stomach And Ileum Flashcards
What are some diseases of the stomach and duodenum
Peptic ulcer disease
Acute gastritis
IBD
Colonic diverticula
Hirschprung’s disease
Malabsorption syndrome (MAS)
What causes peptic ulcer disease
H. pylori or chronic NSAID use
(And also in Zollinger-Ellison syndrome - gastrinoma, or Crohn’s disease)
What is PUD characterized by
One or more ulcerative lesions in the duodenum (most common) or stomach
What are the RFs (risk factors) of PUD
Smoking/Heavy alcohol use (delay healing as well)
Glucocorticoids
Caffeine
Stress
What are the presentations of PUD
Usually asymptomatic but presents as:
Epigastric pain (gnawing/burning)
Dyspepsia
N/V
Bloating
How does acute gastritis come about
It results from acidic damage due to imbalance between damaging and protective factors of the stomach
What are the RFs of acute gastritis
H. pylori
Smoking/heavy alcohol consumption
NSAID overdose
Severe burn (Curling ulcer) or increase ICP (Cushing ulcer)
What are the presentations of acute gastritis
Hematemesis
Melena
Iron deficiency anaemia (IDA)
Epigastric pain
Dyspepsia and early satiety
Microscopy (redness and hyperemia indicating a superficial inflammation)
What are the types of acute gastritis
Type A atrophic gastritis
Autoimmune gastritis
Type B atrophic gastritis
H. pylori gastritis
What is IBD
It is the chronic inflammation of the bowel. It has an unknown etiology
What are the two types of IBD
Crohn’s disease and ulcerative colitis
What is a colonic diverticula
It is the outpouring of only the mucosa and submucosa through the muscularis propria due to intramural pressure (Eg. Constipation due to low fiber or uncontrollable peristalsis) or areas where the muscle is transversed by vessels. It is mostly a false diverticulum
What is the most common location of a colonic diverticulum
Sigmoid colon (narrowest part of the colon)
What are some complications of colonic diverticulum
Usually asymptomatic or with abdominal discomfort and painless hematochezia
Diverticulitis presents with LLQ pain, fever, leukocytosis but no bleeding
What are some complications of a colonic diverticulum
Hemorrhage (most common cause of lower GI bleeding in adults due to session of the surface which causes painless hematochezia
Fistula (most common is a colovesical fistula). Presents with dysuria, air/feces in urine and recurrent UTIs
-Inflammation (diverticulitis) and abscess (persistent fever and abdominal pain despite antibiotic treatment)
Perforation (presents with acite abdomen due to fecal peritonitis)
What are some positional disorders
Volvulus
Intussusception
Ileus
Hurschprung’s disease
Malabsorption syndrome
What is volvulus
Twisting of the bowel along its mesentery
What is the most common site of a volvulus
Sigmoid colon in adults and caecum in children
What is the presentation of positional disorders
Abdominal pain
Distention
Bilous vomiting
Hematochezia or ischaemia
What is intussusception
Telescoping of the proximal segment of the bowel into a distal segment
How do adults mostly get intussusception
Due to tumor
What are some effects of intussusception
Obstruction and ischemia (currant-jelly stool)
What is an ileus
Disruption of the normal propulsive ability of the intestine
What are some causes of an ileus
Drugs (opiates)
Hypokalemia
IBD
Acute pancreatitis
What are some presentations of ileus
Constipation
Pain
Distention (decreased bowel sounds)
Nausea and vomiting
What is Hirschprung’s disease
A birth defect from the neural crest fail to migrate resulting in the absence of myenteric and submucosal plexus
What are some presentations of Hirschprung’s disease
Defective relaxation and peristalsis of rectum and distal sigmoid colon
Affected segment cannot relax and pass stool resulting in localized ileus and megacolon proximally
Bilious vomiting and failure to pass meconium
What is malabsorption syndrome
An impaired intestinal absorption of all types of nutrients
What causes MAS
Insufficient absorption (malfunction of the intestinal wall) or improper digestion of nutrients (insufficient secretion of pancreatic enzymes or bile)
What are the presentations of MAS
Chronic diarrhea (mass and frequency)
Steatorrhea (hallmark of malabsorption)
Anorexia and weight loss
Hypoalbuminemia (edema/ascites)
Dehydration
Vitamin deficiency (B12, folate, K)
Bloating and flatulence
What are the types of MAS
Primary and secondary MAS
What are the examples of the primary MAS
Celiac disease
Topical sprue
Lactose intolerance
What are some examples of secondary MAS
Whipple disease
Crohn’s disease
Gastroenteritis
What are some examples of extra-intestinal MAS
Pancreatic insufficiency
Bile deficiency
Gastritis
