GI Disorders 1 Flashcards
GERD
gastroesophageal reflux diease
reflux of gastic secretions into esophagus
etiology of GERD
incompetent lower esophageal sphincter
hiatal hernia
dec gastic emptying
patho of GERD
reflux into esophagus
acidity causes esophageal irritation/inflam
CM of GERD
heartburn regurgitation diffuculty swallowing gastric symptoms resp symptoms
complications of GERD
scar tissue, esophageal strictures
Barrets esophagus
pneumonia
diagnostic tests for GERD
barium swallow
esophageal endoscopy
treatment for GERD
lifestyle change
meds: antacids, carafate, meds to inc motility, meds to dec acid
Hiatal hernia
protrusion of upper portion of stomach into esophagus thru diaphragm
etiology of HH
unknown
contrib factors: structural changes, weak muscle, inc abd. pressure, hereditary, related to age, excessive lifting, pregnancy
types of HH
sliding
rolling
sliding HH
junction of stomach and esophagus above diaphragm. stomach slides thru when lies down. causes reflux, irritation of esophagus
most common
rolling HH
junction of stomach and esophagus is normal but stomach rolls up thru diaphragm and forms pocket. position causes congestion of mucosal bld flow strangulation of hernia can occur
more dangerous
CM of HH
similar to GERD- both cause GERD
heartburn, reflux
epigastric pain
difficulty swallowing
diagnostic test
same as GERD
treatment for HH
small frequent meals avoid tight clothes antacids surgery wrap part of stomach around esophagus to prevent sliding ---- more complicated
peptic ulcer disease
break/ulceration in GI mucosa from effects of gastric secretions
breaks expose submucosa and cause autodigestion
risk factors for PUD
6 smoking alcohol use of NSAIDS caffeine chronic disease h pylori
types of peptic ulcers
duodenal
gastric
stress
duodenal ulcers
most common
80% of ulcers
excess acid
etiology of duodenal uclers
h pylori
duodenal ulcers more common in
men. women inc. almost evening out.
at any age. typically 35-45 y.o
patho of duodenal ulcers
hypersecretion damages mucosa
inadequate secretion of bicarb
CM for duodenal ulcers
chronic intermittent pain- 2-3 hours after eating when stomach is empty
heal spontaneously- recur seasonal (spring/fall)
recur in middle of night
relieved with food
gastric ulcers
in stomach
equal risk for men and women
typically age 55-65
etiology of gastric ulcers
h pylori, NSAID
patho of gastric ulcers
inc perm. of mucosa for H ions related to duodenal reflux of bile. inc bile salts affect mucosal membrane. damages mucosa releases histamine which inc acid — more damage
CM for gastric ulcers
pain in epigastrum
loss of apetite, wt loss
chronic- no pattern of remission and exacerbation (present at all times)
complications of gastric ulcers
hemmorhage
perforation
diagnostic tests for gastric ulcers
barium x ray
endoscopy
test for h pylori
treatment for gastric ulcers
relieve hyperacidity
meds- antacids, meds to dec acid prod, abx for h pylori
stress ulcers
develop from dec bld flow
form of erosive gastritis
not long term
types of stress ulcers
ischemic
cushing
ischemic stress ulcers
blood shunted away from GI tract. ischemia of mucosa. superficial erosions
cushing stress ulcers
related to overstimulation of vagus nerve
dec bld flow
inc acid
related to head trauma, brain surgery
CM for stress ulcers
bleeding bc gastric irritation
treatment for stress ulcers
prophylactically
antacids
meds to dec acid prod
true ulcers
gastric
duodenal
cause bleeding
not true ulcers
stress
inflam bowel disease
chronic recurrent inflam of intestinal tract
recurs.
period with no symptoms —> exacerbation
etiology of IBD
infection agent
autoimmune
hereditary
types of IBD
ulcerative colitis
crohns disease
