GI and Nutrition Flashcards
Most common cause of hospitalization
GI bleed
Ligament of Treitz
Division of upper and lower GI
Upper GI Bleed Causes
Peptic Ulcer disease
Stress ulcers - caused by ischemia HF, sepsis etc.
Mallory Weiss tear - arterial hemorrhage (NSAID use)
Esophageal Varices - Develop w increase pressure in veins
Normal portal venous pressure
2-6 mm Hg
Peptic Ulcer disease
Most common cause of upper GI blled
In stomach and Duodenum
Breakdown of GI lining develops into muscle
RF - Smoking, H pylori, NSAID use, alcohol abuse
RUQ pain
Stress Ulcer
Occurs w increased acid production
Curling ulcer - Burn pt
Cushing’s Ulcers - head trauma
PPI - pantoprazole Enteral
H2 receptor Parenteral
GERD pain when swallowing
Cormorbidity
Esophageal Varices
Portal Hypertension
Veins become distended and varices develop
In esophagus and upper stomach
Jaundice, weakness, anorexia, abdominal distentiojn
Stool for upper GI bleed
BLACK TARRY Stool - Melena
Mallory Weiss Tear
Where esophagus meets stomach
After forceful vomiting
May need surgical repair. Often self resolvable
Could possibly cause bright red blood in stool. HEMATOCHESIA
Hematochezia in upper GI
Mallory Weiss Tear. RARE major bleed.
Priority for Upper GI
Blood loss
Hemodynamic stability
Fluid resuscitation
Hemodynamic Stability for GI bleed
Oxygen - NC
IV placement
Hemodynamic monitoring
Fluid Resuscitation
Blood Products
Gastric Lavage
Pharmacology Upper GI Bleed
Antacids - pH
PPI - inhibits gastric secretions
H2 - blocks HCl
Prokinetics - strengthens Lower esophageal sphincter
ABX - H pylori
Mucosal barrier - reduces acid secretion
Lower GI Bleed
Diverticulosis - Small outpouching
Angioectasias - Dilation of vessels
Post polypectomy bleeding - Bleeding after polyp is removed
Ischemic Colitis - reduced blood flow to colon
Acute Pancreatitis
Inflammation of pancreas
Causes - Alcoholism, Biliary Disease(Gallstones, Bile duct obstruction, ERCP procedure) Meds, Trauma
