GI and Urinary Diseases

Question 1

what is the two types of swallowing disorders?

Answer 1

esophageal and oropharangeal

Question 2

swallowing is super complex cause

Answer 2

it reuquires coordination of over 50 nerves and muscles

Question 3

3 stages of swallowing

Answer 3

voluntary oral stage

involuntary pharyngeal stage

esopheageal stage

Question 4

Food is chewed and the bolus (food) is forced into the pharynx

Answer 4

voluntary oral stage

Question 5

Pharynx share respiratory tracts, where food bypasses respiratory passages when the soft palate closes the epiglottis, and food travels to the esophagus

Answer 5

involuntary pharyngeal stage

Question 6

Bolus continues to move to the stomach through peristalsis action

Answer 6

Esophageal stage

Question 7

refers to the sensation of food sticking in the esophagus/ base of throat/chest

Answer 7

Esophageal Dysphagia

Question 8

what causes esophageal dysphasia?

Answer 8

Achalasia

Diffuse spasm

Esophageal stricture

Esophageal tumors

Foreign bodies

Esophageal ring

Gastroesophageal reflux disease (GERD)

Question 9

Achalasia (esophageal dyspagia)

Answer 9

lower esophageal muscle (sphincter) doesn’t relax properly, can cause regurgitation of food, tends to get worse over time

Question 10

Diffuse spams (esophageal dysphasia)

Answer 10

produces multiple, high-pressure, poorly coordinated contractions of esophagus after a swallow
affects the involuntary muscles of lower esophagus

Question 11

Esophageal stricture (esophageal dysphasia)

Answer 11

Narrowing of esophagus stricture can cause large pieces of food to get caught

may result from scar tissue, acid reflux or tumors

Question 12

Esophageal tumors (esophageal dysphasia)

Answer 12

Difficulty swallowing tends to get progressively worse when esophageal tumors are present

Question 13

Foregn bodies (esophageal dysphasia)

Answer 13

may partially block the throat or esophagus by food
Older adults with dentures or those with difficulty chewing properly more susceptible
Children may swallow small objects, such as coins or toy pieces

Question 14

Esophageal ring (esophageal dysphasia)

Answer 14

narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods

Question 15

acid reflux (esophageal dysphasia)

Answer 15

Damage to esophageal tissues from gastric acid backing up (refluxing) into your esophagus
can lead to spasm or scarring and narrowing of lower esophagus, making swallowing difficult
Also referred to as acid reflux

Question 16

What type of dysphasia is caused by gastroesophageal reflux disease (GERD)

Answer 16

Esophageal stricture

Question 17

related to throat, nerve. and muscle problems
make it difficult to move food from mouth into your throat
cause may be from brain disorders

Answer 17

oropharyngeal dysphasia

Question 18

Oropharyngeal Dysphagia Chief Manifestations is also called

Answer 18

“high” dysphasia

Question 19

referring to an oral or pharyngeal location
Difficulty initiating swallow
Nasal regurgitation
Coughing
Nasal speech
Diminished cough reflex
Choking

Answer 19

refers to “high” dyspasia

Question 20

swallowing disturbances are found frequently at

Answer 20

in nursing homes, 30–40% of patients have swallowing disturbances = aspiration complications

Question 21

is the passage of food or liquid through the vocal folds into the lungs

Answer 21

aspiration

Question 22

Persons who aspirate are at increased risk for serious respiratory problems
including

Answer 22

airway obstruction and aspiration pneumonia

Question 23

aspiration caused by and may occur with…

Answer 23

often caused by impaired laryngeal closure

May occur with neurological disorders and swallowing dysfunction
overflow of food or liquids retained in the pharynx
gastroesophageal reflux
Aspiration precautions

Question 24

Oropharyngeal dysphagia

Answer 24

Neurological disorders and damage

Pharyngeal diverticula
(collected food particles in the throat, leading to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing

Cancer
Certain cancers and radiation, can cause difficulty swallowing

Question 25

``` These symptoms are for? Pain while swallowing (odynophagia) Unable to swallow Sensation of food getting stuck in throat or chest Drooling Hoarseness Regurgitation Frequent heartburn Food or stomach acid backing up into your throat ```

Answer 25

swallowing disorders

Question 26

Complications of swallowing disorders

Answer 26

``` Malnutrition and dehydration Respiratory problems aspiration pneumonia upper respiratory infections ```

Question 27

food "sticks" after swallowing

Answer 27

esophageal dyspagia

Question 28

difficulty intiating swallowing (may include coughing, choking, or regurgitation)

Answer 28

oropharygneal dysphagia

Question 29

barium x-ray (fluroscopy)

Answer 29

Swallow a barium solution to coat the esophagus, allows the esophagus to show up better on X-rays Able to see changes in the esophagus and assess muscle activity Indications: dysphagia, globus sensation, and aspiration Dynamic swallowing study. swallow foods of different consistencies that have been coated with barium helpful for diagnosing oropharyngeal dysphagia Barium is an X-ray absorber and appears white on X-ray film. barium coats the inside wall of the esophagus, stomach, or intestine Makes visible on x-ray the inside wall lining, size, shape, contour, and patency (openness) Fluoroscopy is often used during a barium study to study moving body structures—similar to an X-ray "movie"

Question 30

Esophageal Dysphagia Treatment

Answer 30

Esophageal dilation endoscope with balloon to gently dilate and expand the width of esophagus for tight esophageal sphincter (achalasia) or an esophageal stricture Surgery esophageal tumor, achalasia or pharyngeal diverticula, may require surgery Medications Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid

Question 31

Oropharyngeal Dysphagia OT Treatment

Answer 31

Speech or swallowing therapist (may be an OT) Provide exercises to help coordinate swallowing muscles or re-stimulate the swallowing reflex Teach swallowing techniques simple ways to place food in mouth or to position body and head

Question 32

If someone has difficulty initiating swallowing, which type of dysphagia do they likely have?

Answer 32

Oropharyngeal

Question 33

acid reflux is known as!

Answer 33

Gastroesophageal Reflux Disease

Question 34

acid reflux happens when

Answer 34

gastric juice refluxes into the esophagus

Question 35

acid reflux causes symptoms with or without

Answer 35

esophageal mucosal injury (esophagitis)

Question 36

what is linked to GERD?

Answer 36

obesity (chronic) and esophagitis

Question 37

Typical esophageal symptoms | for acid reflux

Answer 37

Heartburn Regurgitation Dysphagia

Question 38

Abnormal reflux can cause atypical (extraesophageal) symptoms, such as:

Answer 38

``` Coughing and/or wheezing Hoarseness, sore throat Otitis media Noncardiac chest pain Enamel erosion or other dental manifestations ```

Question 39

GERD Diagnosis is confirmed via

Answer 39

Upper gastrointestinal endoscopy /esophagogastroduodenoscopy Esophageal manometry small, flexible high-resolution manometry catheter through nose, down esophagus and into stomach helps surgical planning by determining the lower esophageal sphincter (LES) pressure helps identify esophageal motility disorders

Question 40

GERD Treatment

Answer 40

antacids or PROTON PUMP INHIBITORS= decrease stomach acid production many side effect risks treatment based on lifestyle modification and control of gastric acid secretion surgery w anti-reflux surgery

Question 41

goal of acid reflux treatment

Answer 41

control symptoms heal esophagitis and prevent esophagitis

Question 42

IBS is caused by

Answer 42

caused by changes in how the GI tract works

Question 43

In IBS symyptoms may be

Answer 43

symptoms may be frequent but GI tract not damaged

Question 44

common symptoms of IBS

Answer 44

abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both

Question 45

IBS is diagnosed when

Answer 45

abdominal pain or discomfort occurs at least 3x per month for the last 3 months

Question 46

IBS affects 2x as many

Answer 46

women than men

Question 47

Possible causes of IBS

Answer 47

Brain-gut interaction - genetic - intestinal infection - chronic stressful life events or psychosocial factors ``` Abnormal motility (movement) Slow motility can lead to constipation and fast motility can lead to diarrhea ``` Psychological anxiety, depression Bacterial gastroenteritis Infection stomach and intestines caused by bacteria Food sensitivity foods rich in carbs spicy or fatty foods, coffee, and alcohol Visceral hypersensitivity stretch on intestines from even small amounts of food may produce discomfort

Question 48

diagnosis of IBS

Answer 48

Medical history questions to ask: questions about symptoms, family history of GI disorders, recent infections, medications stressful events related to the onset of symptoms For IBS to be diagnosed symptoms must have started at least 6 months prior and must have occurred at least 3 days per month for the previous 3 months

Question 49

IBS treatment

Answer 49

No cure symptoms can be treated with a combination of the following: changes in eating habits, diet, and nutrition smaller more frequent meals, avoid high fat foods, increase or decrease fiber, eliminate other problematic foods Medications fiber supplements, laxatives for constipation, antidiarrheals, antispasmodics antidepressants for those with moderate or severe IBS reduce IBS sx to include pain and to normalize GI motility Probiotics live microorganisms, usually bacteria, similar to microorganisms normally found in the GI tract Bifidobacteria and certain probiotic combinations found to improve symptoms of IBS when taken in large enough amounts Therapies for psychological issues to help reduce stress and improve symptoms

Question 50

IBS

Answer 50

Antidepressants can be effective as analgesics used to treat chronic pain conditions as migraine headaches, diabetic neuropathy and fibromyalgia Similarly, antidepressants are effective in treating symptoms of IBS and other functional GI disorders Patients who take antidepressants for IBS report significant improvement in their abdominal pain and reduction in other IBS symptoms

Question 51

colitis

Answer 51

inflammation of the colon

Question 52

IBD is a term for what?

Answer 52

Inflammatory bowel disease (IBD) is a generic term for three disorders associated with GI tract inflammation: Crohn disease Ulcerative colitis Indeterminate colitis

Question 53

Group of disorders in which the intestines become inflamed Most common forms of IBD are ulcerative colitis and Crohn’s disease IBD runs in families, with possible genetic factors Thought that immune system may trigger IBD Immune system seems to overreact to normal bacteria in the digestive tract and fails to "shut off," causing inflammation

Answer 53

inflammatory bowel disease

Question 54

Ulcerative colitis is slightly more common

Answer 54

males

Question 55

Crohn’s disease is marginally more frequent

Answer 55

in women

Question 56

IBD etiology

Answer 56

Etiology is unknown but is thought to involve genetic, immunologic, and environmental factors as evidenced by the following: greatest relative risk of IBD disease is found among first relatives, suggesting a strong genetic component Smoking is one of the more notable environmental factors Ulcerative colitis is more prevalent among ex-smokers and nonsmokers whereas Crohn’s disease is more prevalent among smokers

Question 57

chronic inflammatory IBD condition of the gastrointestinal tract most commonly affects the end of the small bowel (the ileum) and the beginning of the colon, but it may affect any part of the GI tract less able to absorb food nutrients, so body may not get enough nutrients

Answer 57

Crohn's Diease

Question 58

undigested food that goes into the large intestine makes water absorption harder, causing diarrhea can be both painful and debilitating, and sometimes may lead to life-threatening complications no known cure, but therapies can greatly reduce symptoms and even bring about long-term remission

Answer 58

Crohn's Disease

Question 59

Ulcerative colitis

Answer 59

IBD disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon) Most people are diagnosed before the age of 30 Cause is unknown, but may be immune system overreacting to normal digestive tract bacteria Small intestine absorbs nutrients as it should, but inflammation in the large intestine keeps it from absorbing water, causing diarrhea

Question 60

IBD Diagnostics

Answer 60

``` Health & family history, physical exam, and different tests Blood tests to find signs of inflammation and anemia Stool sample tested for blood and infection Colonoscopy or sigmoidoscopy unable to reach small intestine X-rays with barium (orally or as enema) Computerized axial tomography (CT or CAT scan) Capsule endoscopy ```

Question 61

IBD treatment options

Answer 61

Cause unknown – no proven prevention Medications to reduce the inflammation, relieve symptoms, and prevent flare-ups, immune system suppressants, antibiotics (for Crohn’s) Surgery 25-40% with ulcerative colitis will need surgery at some point. Surgery that removes the entire large intestine can completely cure ulcerative colitis also reduces risk of colon cancer 65-75% with Crohn's disease need surgery at some point to relieve symptoms and correct problems like strictures, fistulae, or bleeding in the intestine since Crohn's disease occurs in patches, surgery cannot cure ``` Changes in diet and nutritional supplements Avoid greasy or fried foods Avoid cream sauces and meat products Avoid spicy foods Avoid foods high in fiber, such as nuts and raw fruits and vegetables Eat smaller, more frequent meals Reducing stress and getting enough rest stress does not cause IBD but stress can cause a flare-up ```

Question 62

Probiotics is a form of treatment for which condition?

Answer 62

A. Ulcerative colitis B. Crohn’s disease C. Irritable bowel syndrome (IBS) D. Inflammatory bowel disease (IBD)