GI 2 Flashcards
What are the two types of GI pain?
- cramping pain - on and off
2. unremitting - persistent, never-relaxing
what is dumping syndrome?
it is a problem with gastric emptying –> the stomach empties too fast. the cause is idiopathic or caused by bariatric surgery - smaller gastric size.
increased risk as your BMI goes up
what is Bariatric surgery?
resection of part of the gastric area/volume to lower
how is obesity bad for you? what influence does the bariatric surgery have on it?
obesity causes type 2 diabetes (insulin resistance), increased CV problems, arthritis
bariatric surgery –> developed to be ‘cure’
bariatric surgery was intended for? what is the general basis of the surgery?
bariatric surgery was developed to treat the morbidly obese. The basis is - decreased gastric volume and decrease the gastric size (cause of dumping syndrome). A by-pass of the intestine can also be done to also decrease GI volume/size.
what kind of bariatric surgeries are there?
a. Roux-en-Y By-pass - 40% - gold standard
b. gastric banding –> 40% - no longer used
c. sleeve gastrectomy –> 4%
what are some trends and complications of the bariatric surgery
very expensive, esp. Roux en Y
many people have to return to the hospital
long process - many follow up check-ups
low mortality
number of surgeries per year is increasing
t or f - after bariatric surgery, patients see a 35% decrease in body weight with a secondary benefit of reduced type 2 diabetes.
true
there are significant benefits of bariatric surgery as it removes obesity and obesity-related risks (type e 2 diabetes) - however, there is not ‘not risk’ associated with this procedure
what is gastroparesis?
recall paresis - something that is functioning at a reduced capacity
gastroparesis = slow emptying - opposite of dumping syndrome
often secondary to diabetes
gastric contents stimulates the pyloric sphincter to open and let chyme into the duodenum. however, if there is acid, fat, or a hypertonic solution in the duodenum then through neural and hormal signals, gastric emptying is inhibited - t or f?
true
gastric contents stimulates the ENS short reflexes which cause gastric secretions and mixing contractions. These lead to signals that stimulate pyloric opening. t or f
true
what gastric processes are compromised in type 2 diabetes
a. neural and hormonal inhibition of gastric contraction is NOT compromised
b. ENS reflexes leading to churning and pyloric opening are compromised
- leads to gastroparesis
what is pyloric stenosis?
this is when the pyloric sphincter is stuck in a contracted state - usually seen in a newborn child. here, there is no inhibitory innervation from the ENS
solely an ENS defect
what are the main functions of the liver (GI) and gallbladder?
liver –> produces bile, all blood from the GI tract first goes to the liver, it detoxifies the blood, deals with fat metabolism
- bile production is continuous
gallbladder -> stores bile and contracts it into the GI tract when it’s needed.
what is biliary colic?
sustained or transient blockage of bile outflow leading to pain. this can cause the bile to crystallize and develop gallstones.
pain is an important symptom - gets people into the hospital faster
t or f, 10-20% of adults have stones, while 1/3 have symptoms
true
what occurs of stones cause perforations?
60% mortality
explain the removal of gallstone, lithotripsy, and dissolution drugs
these are treatments for gallstones
lithotripsy is when you use sound waves or MRI waves to break up the stone and allow for its clearance
what is jaundice?
increased levels of bilirubin in the blood causing yellow skin and eyes
what are three generalized causes of jaundice?
- hemolytic jaundice- RBC’s breaks down and leaves a lot of bilirubin in the blood - liver is overloaded
- the liver cannot get rid of enough of the bilirubin in the blood (by converting it into bile) - liver is compromised
- the liver is obstructed from removing bilirubin - e.g. biliary colic
what virus is a common cause of jaundice?
hepatitis
what is hepatitis? how do you get it? what does it do?
hepatitis is an inflammatory condition of the liver caused by viral infection. (other causes of hepatitis can occur, e.g. autoimmune, but more rare)
transmitted through blood or body fluids
hepatitis damages liver function making it less able to get rid of bilirubin (and other metabolites) –> jaundice
hepatitis A is very contagious?
yes, A is very contagious
explain hepatitis A
hepatitis A is the most common cause of hepatitis.
infectious hepatitis
infection comes from water/environment
acute (i.e rapid onset)
It can occur in individual situations or in epidemics. during this infection, you get sick fast –> stool turns white. normally you recover on your own unless immunocompromised.
