Gastrointestinal Disorder (Part 2) Flashcards
OTC drugs for GERD
Antacids
H2RAs (H2 receptor antagonists)
Proton Pump Inhibitor (PPI)
Prescription Medication for GERD
Prokinetics
H2RAs
PPIs
Prescription Medication for GERD
Prokinetics
H2RAs
PPIs
First-line treatment for PUD, if due to H. pylori, is “
Triple Therapy
2 antibiotics
1 PPI
Example of triple therapy
- clarithromycin
- amoxicillin or metronidazole
plus - proton pump inhibitor (e.g. omeprazole).
r, in chronic ulceration or in gastric outlet obstruction
there is still an important role for
truncal vagotomy
ANTISECRETORY THERAPY
AHPMA
Antacids.
2. Histamine (H2) blockers
3. Proton pump inhibitors (PPIs)
4. Medications to protect and strengthen the mucous lining of
the stomach. (bismuth subsalicylate/Pepto-Bismol)
5. Antibiotics to treat H. pylori if it is detected
abnormal, enlarged veins in the tube that
connects the throat and stomach
ESOPHAGEAL VARICES
Esophageal varices develop
when normal blood flow to the liver is blocked by
clot or scar tissue in the liver.
opening in the diaphragm through which the
esophagus passes becomes enlarged
HIATAL (HIATUS) HERNIA
Heartburn, regurgitation, and dysphagia; at least half
of cases are asymptomatic *NO REFLUX
SLIDING HERNIA
Sense of fullness or chest pain after eating or may be
asymptomatic with refluz
PARAESOPHAGEAL HERNIA
COMPLICATIONS: of Paraesophhageal hernia
HOS
hemorrhage, obstruction, and strangulation
possible.
DECREASING RISK OF ASPIRATION for hernia
- keep in a semi-Fowler’s position.
- Instruct patient in the use of oral suction to decrease risk of
aspiration.
(Billroth I)
Vagotomy and Antrectomy with Gastroduodenal
Reconstruction
Gastrojejunal Reconstruction
(Billroth II)
s surgery to widen the opening in the lower part of
the stomach (pylorus) so that stomach contents can
empty into the small intestine (duodenum)
PYLOROPLASTY
to reduce the rate
of gastric secretion.
VAGOTOMY
All the parasympathetic supply from the stomach to the left
side of the transverse colon relies on the
e vagus nerves.
cuts the nerve at the gastroesophageal
junction
truncal vagotomy
lasts several hours to a few days and is often caused
by dietary indiscretion
ACUTE GASTRITIS
prolonged inflammation of the stomach that may
be caused either by benign or malignant ulcers o
CHRONIC GASTRITIS
abdominal discomfort, headache, lassitude, nausea,
anorexia, vomiting, and hiccupping
ACUTE Gastritis
May be asymptomatic. anorexia, heartburn after
eating, belching, a sour taste in the mouth, or nausea and
vomiting., vitamin B12 deficiency
CHRONIC GASTRITIS
CHRONIC GASTRITIS MANAGEMENT
offer ice chips and clear liquids when symptoms
subside.
▪ Encourage patient to report any symptoms suggesting
a repeat episode
CHRONIC GASTRITIS MANAGEMENT
offer ice chips and clear liquids when symptoms
subside.
▪ Encourage patient to report any symptoms suggesting
a repeat episode
the whole stomach is removed
TOTAL GASTRECTOM
the lower part of the stomach is removed
PARTIAL GASTRECTOM
the left side of the stomach is removed
SLEEVE GASTRECTOMY
top part of the stomach and part of the
oesophagus (gullet), the tube connecting your throat
to your stomach, is removed
OESOPHAGOGASTRECTOMY
Complications of Gastrectomy
BDGDE
BLEEDING – anastomosed sit
● DUODENAL STUMP LEAK
● GASTRIC RETENTION
● DUMPING SYNDROME (subtotal gastrostomies)
Early – 10 - 30 mins after meals
S/S = vertigo, tachycardia, syncope, sweating, pallor,
palpitations
IRRITABLE BOWEL SYNDROME/ IBS
Also called
spastic colon, irritable colon, or nervous stomach
e low-FODMAP diet
(fermentable oligosaccharides, disaccharides,
monosaccharides, and polyols)
can affect any part of the GI tract but most
commonly affects the terminal ileum and large
intestine, w
CROHN’S DISEASE
CAUSES: genetics and family history
CROHN’S DISEASE
TREATMENTCROHN’S DISEASE
TMS
topical pain relievers
● immunosuppressants
● surgery
a birth defect that occurs when the intestines do not
correctly or completely rotate into their normal final
position during development.
MALROTATION
MALROTATION
S/S
A baby with cramping might:
● pull up the legs and cry
● stop crying suddenly
● behave normally for 15 to 30 minutes
● repeat this behavior when the next cramp happens
part of the intestine folds into itself, much like a
collapsible telescope. A common cause of intestinal
obstruction.
INTUSSUSCEPTION
a part of the colon is completely blocked or missing
COLONIC ATRESIA
part of the colon is more narrow than normal.
COLONIC STENOSIS,
saclike herniation of the lining of
the bowel that extends through a defect in the muscle
layer
DIVERTICULUM
s considered a major
predisposing factor.
DIVERTICULITI
low intake of dietary fiber
results when food and bacteria retained
in the diverticulum produce infection and inflammation
DIVERTICULITIS
Bowel irregularity with intervals of diarrhea, nausea and
anorexia, and bloating or abdominal distention.
Diverticulosis; n
Acute onset of mild to severe pain in the left lower quadrant *
Nausea, vomiting, fever, chills, and leukocytosis
Diverticulitis
Diverticulitis
if untreated
, peritonitis and septicemia
dilated veins in the anal canal,
structural disease
Hemorrhoids a
nternal hemorrhoids can
fall down enough to
prolapse (sink or stick) out of the anus.
This very painful
condition is also called a “____” in external hemorr
pile
Prolapse requires manual reduction,
What grade/stage of hemorrhoids?
Grade 3
Prolapse, reduces spontaneously
What grade/stage of hemorrhoids?
2
Prolapse cannot be reduced,
What grade/stage of hemorrhoids?
4
Bleeding, no prolapse
What grade/stage of hemorrhoids?
1
Position for rectal examination of anascope for hemorrhoids?
Prone jack knife position
INTERNAL HEMORRHOIDS
Treatment:
(LIS)
Improve bowel habits
Ligating bands
Surgical removal for a very large, painful and persistent
hemorrhoids.
A HEMORRHOIDECTOMY
is performed in the following settings:
(SSS)
Symptomatic grade III, grade IV, or mixed
Strangulated internal hemorrhoids
- Some thrombosed external hemorrhoid
Procedure for Prolapse
and Hemorrhoids - PPH)
Stapled Hemorrhoidectomy
