Gastrointestinal pt. 1 Flashcards
anorexia
- lack of desire to eat (not always a disease)
- nonspecific
anorexia can be caused by
- side effect of medications, cancer, heart disease, kidney disease
emesis
forceful emptying of the stomach and interstitial contents
emesis can be caused by
extreme pain, stomach or duodenum distention, motion sickness, side effect of medications, trauma
emseis is also know as
vomitting
emesis is usually proceeded by
nausea
vomiting without nausea is known as
projectile vomiting
projectile vomiting can be caused by
direct stimulation of the vomiting centre (tumors, aneurysms. .increase inter cranial pressure)
nausea
- subjective
- abnormal pain, spinning movements, hypersalvation, and tachycardia
consequences of nausea and vomiting
FLUID AND ELECTROLYTE IMBALANCES, ACID/BASE DISTURBANCES
- hyponatremia
- hypokalemia
- hypochloremia
- metabolic alkalosis
constipation
-difficult or infrequent bowel movements
- subjective (depends on normal bowel habits)
primary constipation is caused by
bowel dysfunction or evacuation
secondary constipation
- caused by outside factors
- diet medication, endocrine or neurogenic disorders, pregnancy
retracting
the muscular event of vomiting without the expulsion of vomitus
diarrhea
- presence of loose, watery stool
acute diarrhea
- more than 3 loose stools developing within 24 hours and lasting less than 14 days
persistant diarrhea lasts
14 days to 2 weeks
large volume diarrhea
- volume of feces is increased
- generally caused by excessive amounts of water or secretions or both in the intestines
small volume diarrhea
- volume of feces is not increased
- usually results form excessive intestinal motility
osmotic diarrhea
- nonabsorbale substance in the intestine draws excess water into the intestine and produces large volume diarrhea
osmotic diarrhea causes
- lactase and pancreatic enzyme deficiency; excessive ingestion of synthetic nonabsorbable sugars, full strength tube-feeding formulas, dumping syndrome associate with gastric reaction
secretory diarrhea
excessive mucosal secretion of fluid and electrolytes produces large volume diarrhea
secretory diarrhea causes
infections (rotavirus), bacterial enterotoxins (coli, cholerae), exotoxins from overgrowth following antibiotic therapy (difficile)
small volume diarrhea is usually caused by
inflammatory disorder of the intestine (ulcerative colitis, chrons disease, microscopic colitis, colon cancer or fecal impaction
motility diarrhea
- decreased transit time means decreased reabsorption tine
motility diarrhea is caused by
resection of the small intestine or surgical bypass (short bowel syndrome), fistula formation, IBS, diabetic neuropathy, hyperthyroidism, laxative abuse
steatorrhea
fat in the stool
the small intestine absorbes
most of your carbs, fats, minerals, protein, and vitamins
large intestine absorbes
water and vitamins
systemic effects of prolonged diarrhea common with all types
- dehydration, electrolyte imbalances and weight loss
systemic effects of prolonged diarrhea due to infection
fever, with or without vomiting anf cramping
systemic effects of prolonged diarrhea due to inflammatory bowel disease
fever, cramping, bloody stools
systemic effects of prolonged diarrhea due to malabsorption syndrome
- steatorrhea (fat in the stools), bloating, diarrhea
treatment of diarrhea
- health history to determine underlying cause and intestinal biospy for persistent diarrhea
- restoration of fluid and electrolyte imbalances, antimotility agents, water absorbent medications, correction of nutritional deficiencies
abdominal pain is caused by
mechanical, inflammatory, or ischemic
abdominal organs are sensitive to
stretching and distention (activates nerve endings)
abdominal pain is described as
sharp, dull or colicky
- hard to give a precise location
parietal (somatic) pain
- from the parietal peritoneum
- precisely localizzed and intense
- aggrivated by movement
parietal pain is usually caused by
infection
visceral pain
- arises from a stimulus acting on an organ
- poorly localized, diffuse or vague
visceral pain is caused by
damage or disruption
referred pain
visceral pain is felt away from the disease or affected organ
- well localized, can be felt in the skin or deeper
upper gastro-intestinal bleeding
bleeding in the esophagus, stomach or duodenum
upper gastro-intestinal bleeding is characterized by
HEMATEMESIS (bloody vomitus)
- emesis of frank, bright red bleeding or dark, grainy digested blood “coffee grounds”
upper gastro-intestinal bleeding causes
bleeding esophageal varices, peptic ulcer tear at the esophageal-gastric junction (Mallory-Weiss syndrome) caused by severe retracting
lower GI bleeding
- bleedign from the jejunum, ileum, colon, or rectum
lower GI bleeding causes
- polyps, diverticultis, inflammatory disease, cancer, hemorrhoids
Lower GI bleeding is characterized by
melena and hematochezia
hematemesis
- emesis of frank, bright red bleeding or dark, grainy digested blood “coffee grounds”
melena
- black, sticky, tarry, foul smelling stools characterized by the digestion of blood in the GI tract
hematochezia
fresh, bright red blood passes from the rectum
occult bleeding
trace amounts of blood in normal appearing stools or gastric secretion
occult bleeding causes
slow GI bleeding
blood volume depletion leads to
hypovolemic shock
dysphagia
difficulty swallowing
dysphagia causes
- mechanical obstruction of the esophagus (tumours, strictures
- functional disorder (neural or muscular disorders; parkinsons, MS, muscular dystrophy, or achalasia
discomfort occuring 2-4 seconds after swallowing is assoicated with
upper esophageal obstruction
discomfort occurring 10-15 seconds after swallowing is associated with
obstructions in the lower esophagus
manifestations of dysphagia
- regurgitation of undigested food, unpleasant taste, vomiting, aspiration, and weight loss
Acid reflux
LES is weak or doesnt properly close, allowing stomach acid to backup, which irritates the lining of the esophagus
Acid reflux manifestations
- burning sensation in the chest, pressure or pain in chest, sour, bitter, or acidic taste in the back of your throat
acid reflux modifications
- avoid trigger foods, caffeine, alcohol, stay upright after meals and after, lose weight, stop smoking
Gastroesophageal reflux disease (GERD) is
- more serious form of acid reflux
- reflux of acid and pepsin or bile salts from the stomach into the esophagus
GERD causes
esophagitis
GERD causes
- abnormalities in the llower esophageal sphincter function (resting tone in lower than normal), esophageal motility, gastric motility or emptying
–> vomiting, coughing, lifting bending, obesity, or pregnancy