Gastro disorders Flashcards
Gastrointestinal disorders involve the GI tract and accessory organs what are these?
gi tract ; oesophagus, stomach, small intestine, large intestine, rectum
accessory organs; liver gallbladder and pancreas
what is Gastrointestinal Reflux Disease (GERD) and what is it commonly known as
- irritation of the oesophageal lining by stomach acid due to excessive acid reflux through the lower oesophageal sphincter (cardiac sphincter)
- commonly known as heart burn
which age group is GERD most common in and what external and internal factors may be the cause?
- usually in adults older than 40
- internal factors; diminished oesophageal clearance due to body position, lack of saliva, defective anti-reflux barrier due to hiatal hernia, gastric factors eg. acid production or slowed gastric emptying
- external factors; diet, smoking, medication
what is the usual treatment for GERD and if not managed what is a potential complication of the disease?
- treatment usually meds that decrease stomach acid production (eg, proton pump inhibitor)
- Barretts oesophagus with risk of adenocarcinoma
Gastritis is the most common problem affecting the gut what is this and what are the two forms it can be?
- inflammation of the gastric mucosa
- erosive gastritis and non erosive gastritis
distinguish the difference between the two forms of gastritis and their likely causes
Erosive Gastritis: often doesn’t cause significant inflammation but can wear stomach lining and lead to bleeding, erosions and ulcers. most common cause = prolonged use of NSAIDs
Non erosive gastritis: inflammation is present and most common cause is the Helicobacter Pylori bacteria infection that infects the lining of the stomach
what is the most common test used to diagnose gastritis?
endoscopy with a biopsy of the stomach
what is the treatment for gastritis?
medication that decreases stomach acid can relieve symptoms and promote healing of the stomach lining. These include;
- antacids (neutralise stomach acid)
- histamine 2 blockers (decrease acid production)
- proton pump inhibitors (are more effective than H2 blockers)
remove the cause
What are peptic ulcers
lesions in the stomach (gastric ulcer), duodenum (duodenal ulcer) or oesophagus (oesophageal ulcer) occur due to the lining of these organs being corroded by the acidic digestive juices which are secreted by the stomach cells
what may indicate a gastric ulcer
they can bleed so the presence of blood in vomit or stool
what is the most common type of ulcer and what may cause it
- duodenal ulcer
- may be caused by hypersecretion of acid and pepsin which enters the duodenum or a decrease in bicarbonate production by the pancreas may also contribute
what type of ulcer would be a result of gastric reflux
oesophageal ulcer
what is pancreatitis due to, what happens within the pancreas and what are the symptoms?
- due to local effect of proteolytic enzymes being inappropriately activated rpior to leaving the pancreas and leaking into the interstitial space
- what happens; inflammation, hemorrhage, fat necrosis of pancreatic fat and pancreatic necrosis
- presents with abdominal pain, nausea, fever, vomiting
Pancreatitis can either be acute or chronic describe acute pancreatitis and the common causes
- serum amalyse an serum lipase levels are elevated
- Local: release of enzymes causes inflammation and oedema in the retroperitoneum
- systemic damage can occur when severe
- most common causes are gallstones blocking the common bile duct or alcohol abuse
Pancreatitis can either be acute or chronic describe chronic pancreatitis, its common cause and symptoms
- permenant irreversible damage with fibrosis and loss of function pancratic tissue
- 70% of the time due to chronic alcoholism
- presents chronic but mild abdo pain (intensity increases as gland is progressively damaged) diarrhoea in later stages and weight loss due to malabsorption
how does alcohol abuse cause pancreatitis
alcohol stimulates pancreatic secretions and protein concentrations which gradually plug the ducts
What is coeliac disease? what happens within the small intestine? what is the treatment?
- it is a t cell mediated autoimmune injury of intestinal epithelial cells. the person will have a hypersensitivty gluten.
- antibody/ immune mediated inflammation results in atrophy and flattening of small intestine villi which leads to malabsorption, chronic diarrhoea and pain
- only treatment is a gluten free diet
What is ulcerative colitis, what causes it, and what are the symptoms?
- type of inflammatory bowel disease that affects the lining of the large intestine (colon) and rectum
- the cause is unknown people with this condition issues with their immun system but not sure if this is the cause and symptoms can be triggered by stress and certain foods but dont cause the disease
- symptoms include bloody diarrhoea, left sided abdo ppain and fever
ulcerative colitis is catagorised according to location: - proctitis - proctosigmoiditis - left sided colitis - pancolitis what areas do these include
- rectum only
- rectum and sigmoid colon
- entire left side of colon
- entire colon
where does ulcerative colitis usually begin and what is happening to give the appearance of pseudopolyps?
- begins in the rectum and proceeds to entire colon
- normal mucosa is surrounding ulcerated “humps” to give appearance of pseudopolyps
name five Ulcerative colitis clinical manifestations
- ulceration
- oedema (psuedopolyps)
- rectal bleeding (mild to severe)
- diarrhoea
- lower abdo cramping and pain
what are five complications of ulcerative colitis
- nutritional deficiences
- massive bleeding
- severe diarrhoea causing hypovolaemia
- increased risk of colorectal cancer
- perforation
what is crohn’s disease? what is it characterised by ?
chronic inflammatory disorder characterised by a cobble stone pattern of submucosal ulcers that extend deep into the bowel and form fissures, fibrous scarring and non-caseating granulomas; inter spread with areas of normal bowel (“skip lesions”)
where does Crohn’s disease affect? what is the cause and how is it diagnosed?
- can affect any area of the GI tract; usually colon or distal ileum
- cause is unknown
- diagnosed by an endoscopy
what are the sign’s and symptoms of Crohn’s disease?
- inflammation of the submucosa lymphatics resulting in oedema, abscesses and ulceration
- appearance of mucosa is the cobble stone effect due to ulcers surrounding inflamed mucosa
- mild pain
- anorexia
- fever
progression; fistula formation, malnutrition, diarrhoea
what is diverticulitis?
- process in which pockets or pouches formed on the outside of the colon and large intestine
- pockets are called diverticula; these build up bacteria and infection which results in diverticulitis
what causes diverticulitis and what are the symptoms?
- probably due to low-fibre diet resulting in hard stools causing high pressure in the left colon
- often asymptomatic
- common in elderly
what are polyps?
benign mucosal tutors that may be found along the length of the intestine
Polyps are fairly common how do they turn into cancer?
- colon cancer typically develops when benign colon polyps become malignant and dame intestinal tissue
What are adhesions? what can cause them?
- bands of scar tissue between or around organs
- infection, surgery or trauma may cause adhesions to form
what are the symptoms of adhesions and how can they impact normal organ function?
- can cause abdominal pain and intestinal obstruction
- they can decrease internal volume and block movement of substances
- inhibit ability of muscles to contract
- if in between organs can restrict the normal movements of those organs
How do hernias occur? what are the two types which can cause digestive system disorders?
- when one part of the body protrudes through a gap, tear or opening
- Hiatal hernia
- Inguinal hernia
what is a Hiatal Hernia?
- forms at the opening 9in the diaphragm where the oesophagus joins the stomach
- can allow food to go back up into the oesophagus causing heartburn, chest pain and nausea
what is a Inguinal Hernia?
- occurs when soft tissue often part of the intestine protrudes through a weak part or tear in the lower abdominal wall
- may occur due to muscle weakness, strenuous physical activity excessive weight or excessive coughing
what are the two types of intestinal obstruction?
- mechanical: simple (luminal obstruction) or strangulated (luminal obstruction with Ischaemia)
- Non- mechanical: also called functional; neurogenic (post-operative)
what is Volvus?
a twisting of the intestine
what is an intussusception?
- telescoping (enfolding) of the intestine
what is the pathophysiology of intestinal obstruction? What is happening?
- build up of fluid and gas in the lumen, results in proximal distention to obstruction and distal collapse of intestine
what are the signs and symptoms of intestinal obstruction
- anorexia
- constipation/liquid stools/diarrhoea
- pain
- abdominal tenderness
- nausea and vomiting
what would you hear on auscultation with an intestinal obstruction?
- high pitch gurgling if mechanical
- if non mechanical you would hear either no or diminished sounds
what is a perforation?
Hole in the GI tract wall due to disease or trauma
- acute emergency, severe pain, risk of peritonitis
what is peritonitis?
infection of the peritoneal cavity due to perforation or transduction of toxic intestinal contents in the peritoneum
