Exam 2 - Gastrointestinal system Flashcards
digestion
Mechanical = teeth, churning, etc
chemical = enzymes
*most digestion occurs in small intestines
absorption
-almost all and 80% of water absorption occur in small intestine (specific jejunum)
Regulation of digestive tract
- autonomic nervous system
- endocrine (gastrin, secretin, cck)
- paracrine (histamine and prostaglandins)
common problems with GI issues
- malnourishment
- vitamin and mineral deficiencies
- anorexia
- cachexia (wasting syndrome)
- dehydration
- osteoporosis
- anemia
- clotting disorders
- weakness, fatigue, de-conditioning
GI signs and symptoms
- nausea
- vomiting
- diarrhea
- constipation
- dysphagia
- heartburn
- abdominal pain
- GI bleeding (poop stuff)
- fecal incontinence
Causes of nausea/vomiting
general stuffffff
-neurological
= inc intracranial pressure, concussion, homorrhage, vestibular, migraines)
Achalasia (what is it)
-inc tone of lower esophageal sphincter (LES) - failure to relax normally when swallowing
causes chest pain, fullness, dysphagia.
can lead to dilatation of the esophagus and lack of peristalsis
Achalasia (why)
- loss of myenteric ganglion cells and inhibitory neurons, reduced NO production likely play a role
- may occur cuz of other disorders
treat: pneumatic balloon dilation, myotomy, nitrates, botox
Gastroesophageal reflux disease GERD
-inflammation of esophagus resulting from reflux of stomach acid into esophagus
GERD causes
- reduced pressure in LES
- inc gastric or intra-ab pressure
- position
it is common
-fat people, age, what you eat and drink, etc
GERD signs and symptoms
- chest pain
- burning (heartburn)
- dysphagia and/or painful swallowing
- belching
- indigestion
- regurgitation
- chronic cough
- laryngitis
-long term can inc risk of cancer and pulmonary complications (barrett esophagus)
Treating GERD
- lifestyle
- meds (antacids, H2 receptor blocks, proton pump inhibitors)
- surgery
Hiatal hernia
- hernia of stomach through diaphragm
- due to weak diaphragm or inc intra-ab pressure (aging, trauma, etc)
signs: like GERD
med treatment: like GERD. surgery if severe
Esophageal cancers (types, signs, treatment, prog)
- squamous cell carcinoma
- adenocarcinoma
signs: pain with swallowing, wt loss, hematemesis, chest pain, hoarseness, fistula thingy
treat: prevent. or do surgery, radiation, chemo
prog: most detected late. survival bad
Squamous cell carcinoma
- most common worldwide
- more common in blacks in US
- risk factors: alcohol, tobacco, achalasia, nutritional deficiencies
Adenocarcinoma
Esophageal cancer
- rising incidence in the US
- more common in middle aged caucasian men
- barrett esophagus most common cause
What is Gastritis?
inflammation of the lining of the stomach (gastric mucosa)
Acute hemorrhagic and chronic
Acute hemorrhagic gastritis
- characterized by erosion of mucosal epithelium
- associated with ASA/NSAIDs, EtOH, and stress
Chronic gastritis
Type A: rare, links to autoimmune disorders
Type B: more common, liked to H. pylori infection
Gastritis (symptoms and treatment)
symptoms
- epigastric pain, ab distension, loss of appetite, nausea, GI bleeding
- may develop anemia
Treat:
- avoid irritation
- PPIs, antacids, H2 blocks, antimicrobials for H. pylori
what is Peptic ulcer disease (PUD)
- deeper ulceration in stomach or duodenum
- 90% caused by H. pylori
- can involve mucosa, submucosa, and muscular layers
- chronic inflam is bad
PUD signs and treatment
signs
-ab pain, loss of appetite, nausea/vomiting
treatment
-antibiotics, antacids, pump inhibitors, H2 blockers, stop using ASA/NSAIDs, surgery
Pyloric stenosis
- obstruction of pyloric sphincter (stomach -> duodenum)
- congenital or acquired
symptoms: projectile vomit, node in RUQ (infants)
Diag: ultrasound
Treat: surgery
Gastric cancer
-adenocarcinoma = most common
treatment: surgery, chemo
Prog: depends on severity
Malabsorption syndrome
- reduced intestinal absorption of food and lose nutrients in poo
- either maldigestion or malabsorption
- many causes: celiac, CF, crohns, etc
- common nutrients: fat, iron, mg, K, vit K/B12/D
Crohn’s vs ulcerative colitis
Crohn’s
- any segment. usually small or large intestines
- entire intestinal wall involved
Ulcerative colitis
- Large intestine. Rectum
- more superficial layers
Inflammatory bowel disease
- inappropriate immune response as a result of a lot of factors.
- Crohn’s and ulcerative colitis
Treat: drugs, diet, surgery
*increases risk of cancer
Irritable bowel syndrome (IBD)
- functional disorder of GI motility - absence of inflammation, no identifiable abnormality of the bowel
signs: diarrhea and constipation, bloating
diag: depends
Treat: diet, meds, stress management etcccccc
Diverticular disease
- herniation of large intestinal mucosa and submucosa through muscle layers of intestinal wall
- sigmoid colon most common
What is diverticulitis?
When poo is trapped in diverticula and gets infected
Bowel obstruction
Mechanical = physically blocked Functional = lack of parastalsis
treat: restricted oral intake, NG tube, surgery
what is a Hernia?
Protrusion of the intestine through fascial defect in the ab wall
What are hemorrhoids?
varicose veins of the anus and lower rectum
Treatment is typically to reduce pain and itching. may need surgery chronically
What is appendicitis
- inflammation of appendix
- McBurney’s point
Treat: remove it and antibiotics
Colon cancer
- Adenocarcinoma of colon is more common malignancy of the GI tract
- 2nd leading cause of cancer death in US
- often slow growing. starts with a polyp
- cellular hyperplasia and transformation
Prevent: screening. 50 yrs old. every 5-10 yrs
symptoms: bloody poo. ETC
