GI Disorders

Question 1

Esophageal Disorders

Answer 1

Dysphagia

Achalasia

Diverticulum

GERD

Barrett’s Esophagus

Esophageal Varices

Question 2

Gastric and Intestinal Disorders

Answer 2

Gastritis

Peptic Ulcer Disease

Inflammatory Bowel Disease

Crohn’s Disease

Ulcerative Colitis

Obstruction

Cancer

GI Bleeding

Question 3

Achalasia

Answer 3

Impaired esophageal peristalsis with failure of the lower esophogeal sphincter to relax

Question 4

Diverticulum

Answer 4

Outpouching of the wall

Question 5

GERD

Answer 5

Symptoms and tissue damage associated with reflux of gastric contents

Contributing Factors:

• Weak lower esophageal sphincter
• Impaired gastric emptying
• Hiatal hernias
• Alcohol

Question 6

Barrett’s Esophagus

Answer 6

Transformation of the normal esophageal equamous epithelium to columnar epithelium

(Increased risk of esophageal cancer)

Question 7

Esophageal Varices

Answer 7

Dilated veins associated with liver cirrhosis

• Lower 1/3rd of the esophagus
• Beneath mucosa
• Collarteral veins develop
• Increased risk of rupture

Question 8

Gastritis

Answer 8

Inflammation of the inner lining of the stomach

• Acute
• Stress-Induced

Question 9

Peptic Ulcer Disease

Answer 9

Increased acid secretions and digestive enzymes erode gastric mucosa (H. pylori)

• Hemorrhage
• Perforation peritonitis
• Scarring

Question 10

Pancreatitis

Answer 10

An inflammation of the pancreas causing severe abdominal or epigastric pain often radiating to the back

Chronic: excessive alcohol consumption

Acute: presence of choleliathiasis

…think trypsin…

Question 11

Crohn’s Disease

Answer 11

Regional Enteritis

Progressive inflammation primarily of the distal ileum and colon causing thickening and scarring of the entire bowel wall

Question 12

Ulcerative Colitis

Answer 12

Recurrent chronic inflammation of colon and rectum effecting the mucosal layer of the intestine

Question 13

Diverticulosis

Answer 13

Outpouching of mucosa and submucosa through the intestinal wall

-osis … -itis

Diverticulitis: infection and inflammation of diverticuli

Question 14

Adhesions

Answer 14

…can lead to small bowel obstruction (leading cause of SBO in adults)

Question 15

Hiatal Hernia

Answer 15

The gastroesophageal junction moves above the diaphragm with some of the stomach

Question 16

Ventral Hernia

Answer 16

An incision-related hernia where abdominal contents protrude through the linea alba

Question 17

Inguinal Hernia

Answer 17

Protrusion of abdominal-cavity contents through the inguinal canal

Question 18

Hemorrhoids

Answer 18

Swelling and stretching of the veins around the anal canal

Constipation and increased straining predispose to development

Question 19

Gastrointestinal Bleeding

Answer 19

Continued bleeding and rebleeding are the highest predictors of mortality and morbidity in older patients

Question 20

-ostomy

Answer 20

refers to the surgically created opening in the body for the discharge of body wastes

Question 21

-stoma

Answer 21

is the end of the small or large bowel that is protruding through the abdominal wall

There is a stigma to having this outside the body… be comfortable

Question 22

Esophagectomy

Answer 22

Transhiatal esophagectomy (THE): performed on the neck and abdoment simultaneously

Transthoracic esophagectomy (TTE): involved opening the thorax (thoracotomy or sternotomy)

Question 23

Common Post-Operative Complications

Answer 23

Pain

PUlmonary complications

Bleeding

Infection

Question 24

Mobilization Considerations

Answer 24

Pain and pain control

“log roll”

Valsalva (limit)

Lab Values and volume status

Feeding tubes