GI & GU SYSTEMS Flashcards
GI DISEASE - DEFINITION
- Gastrointestinal diseases affect the GI tract from the mouth to the anus
- There are 2 types: functional and structural
GI DISEASE - SIGNS AND SYMPTOMS
- Bloating
- Excess gas
- Constipation
- Diarrhoea
- Heart burn
- Nausea and vomiting
- Abdominal px
- Incontinence
- Weight loss
- Blood in stool
- Px
- Difficulty swallowing
- Changes in appetite
ABDOMINAL PAIN - SITE - DEFINITION
Abdominal px is px that is felt anywhere between the chest and groin
ABDOMINAL PAIN - SITE - GENERALISED
o Appendicitis
o Crohn’s disease
o Traumatic injury
o IBS
o UTI
o Flu
ABDOMINAL PAIN - SITE - LOWER ABDOMEN
o Appendicitis
o Intestinal obstruction
ABDOMINAL PAIN - SITE - LOWER ABDOMEN (FEMALES)
o Ectopic pregnancy
o Dysmenorrhea (severe menstrual px)
o Ovarian cysts
o Miscarriage
o Fibroids
o Endometriosis
o Pelvic inflammatory disease
ABDOMINAL PAIN - SITE - UPPER ABDOMEN
o Gallstones
o Heart attack
o Hepatitis
o Pneumonia
ABDOMINAL PAIN - SITE - CENTRAL ABDOMEN
o Appendicitis
o Gastroenteritis
o Injury
o Uraemia (build-up of waste products in the blood)
ABDOMINAL PAIN - SITE - LOWER LEFT ABDOMEN
o Crohn’s disease
o Cancer
o Kidney infection
o Ovarian cysts
o Appendicitis
ABDOMINAL PAIN - SITE - UPPER LEFT ABDOMEN
o Enlarged spleen
o Faecal impaction (hardened stool that can’t be eliminated)
o Injury
o Kidney infection
o Heart attack
o Cancer
ABDOMINAL PAIN - SITE - LOWER RIGHT ABDOMEN
o Appendicitis
o Hernia
o Kidney infection
o Cancer
o Flu
ABDOMINAL PAIN - SITE - UPPER RIGHT ABDOMEN
o Hepatitis
o Injury
o Pneumonia
o Appendicitis
ABDOMINAL PAIN - NATURE - TYPES
- Mild or severe
- Dull or sharp
- Burning or achy
- Crampy or colicky
- Constant or intermittent
- Localised (in one spot) or generalised (all over)
ABDOMINAL PAIN - NATURE - GENERALISED PAIN
- Means that the pt feels it in more than half of their abdomen
- This type of px is typical for
o Stomach virus
o Indigestion
o Gas - If the px becomes more severe it can be caused by a blockage of the intestines
ABDOMINAL PAIN - NATURE - LOCALISED PAIN
- Px found in only one area of your belly
- More likely to be a sign of a problem in an organ
ABDOMINAL PAIN - NATURE - CRAMPY PAIN
- Most of the time not serious
- Likely due to gas and bloating and is often followed by diarrhoea
- More worrisome signs include px that
o Occurs more often
o Lasts longer than 24 hours
o Occurs with a fever
ABDOMINAL PAIN - NATURE - COLICKY PAIN
- Px that comes in waves
- Often starts and ends suddenly
- Often severe
- Kidney stones and gallstones are common causes of this type of px
ABDOMINAL PAIN - SPEED OF ONSET - SUDDEN
- Occurs within a second
- Pt will relate the time of onset at a precise moment, usually stating exactly what activity was going on at the time the px began
- Commonly associated with
o Perforation of the gastrointestinal tract from a gastric or duodenal ulcer
o A colonic diverticulum
o Foreign body
o Ruptured eptopic pregnancy
o Mesenteric infraction
o Ruptured aortic aneurysm
o Embolism of an abdominal vessel
ABDOMINAL PAIN - SPEED OF ONSET - RAPID
- Begins with a few seconds and increases in severity over the next several minutes
- Pt will recall the time of onset in general but without the precision noted in px of sudden onset
- Associated with
o Cholecystitis
o Pancreitis
o Intestinal obstruction
o Diverticulitis
o Appendicitis
o Ureteral stone
o Penetrating gastric or duodenal ulcer
ABDOMINAL PAIN - SPEED OF ONSET - GRADUAL
- Px that comes on slowly and becomes more severe after a number of hours or even days have elapsed
- Pt memory as to the time of onset of the px is vague; they can only pinpoint the day or maybe the week of onset
- Generally associated with
o Neoplasms
o Chronic inflammatory processes
o Large bowel obstructions
ABDOMINAL PAIN - PROGRESSION
- Its of real diagnostic significance to determine the progression of the px over the interval of the time of onset until the pt seeks medical attention
o Has the px abated or increases?
o Have there been intervals of total absence of the px or has the px always been present, changing only in character?
ABDOMINAL PAIN - ASSOCIATED FEATURES
- Symptoms that accompany abdominal px are important in making an accurate diagnosis
- Some of the most important symptoms are
o Nausea
o Vomiting
o Abdominal distention
o Diarrhoea
o Constipation
o Obstipation
o Tarry stools
o Chills
o Fever
o Urinating frequently
o Haematuria
o Jaundice
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - DEFINITION
- Occurs when the acid from the stomach leaks up into the oesophagus
- Usually occurs as a result of the ring of muscle at the bottom of the oesophagus becoming weakened
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - CAUSE
- Caused by frequent acid reflux or reflux of nonacidic content of the stomach
- When you swallow, a circular band of muscle around the bottom of the oesophagus relaxes to allow food and liquid to flow into the stomach, the sphincter then closes again
- If the sphincter does not relax as it should or it weakens, stomach acid can flow back into the oesophagus
- This constant backwash of acid irritates the lining of the oesophagus, often causing it to become inflamed
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - POPULATION AFFECTED
Younger adults and teenagers
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - RISK FACTORS
- Obesity
- Hiatal hernia
o Bulging of the top of the stomach up above the diaphragm - Pregnancy
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
Factors that can aggravate acid reflux include - Smoking
- Eating large meals or eating late at night
- Eating certain foods such as fatty or fried foods
- Drinking certain beverages, such as alcohol or coffee
- Taking certain medications, such as aspirin
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - CLINICAL PRESENTATION
- Heart burn
o Usually after eating, which might be worse at night or while lying down - Regurgitation of food or sour liquid
o Backwash - Upper abdominal or chest px
- Dysphagia (trouble swallowing)
- Sensation of a lump in your throat
- If you have nighttime acid reflux other symptoms may be
o An ongoing cough
o Laryngitis (Inflammation of the vocal cords)
o New or worsening asthma
GASTROESOPHAGEAL REFLUX DISEASE (GORD) - PROGNOSIS
- Managed with OTC medications
o Antacids
o An H2 receptor blocker
o Proton pump inhibitor - If these don’t work a doctor can prescribe
o Sucralfate
o Metoclopramide - Often simple lifestyle changes help relieve symptoms
PEPTIC ULCER DISEASE - DEFINITION
- Peptic ulcers are sores that develop on the inside lining of your stomach and the upper portion of your small intestine
- Peptic ulcers include
o Gastric ulcers that occur on the inside of the stomach
o Duodenal ulcers that occur on the inside of the upper portion of your small intestine
PEPTIC ULCER DISEASE - CAUSE
- Occur when the acid in the digestive tract eats away at the inner surface of the stomach or small intestine
- Common causes are
o A bacterium
Helicobacter pylori bacteria
o Regular use of certain pain relievers
Aspirin
NSAIDs
o Other medications
Steroids
Anticoagulants
SSRIs
PEPTIC ULCER DISEASE - POPULATION AFFECTED
- Gastric ulcers
o Tend to occur later in life, after 60, and affect more women than men - Duodenal ulcers
o Tend to appear between 30 and 50 and affect more men than women
PEPTIC ULCER DISEASE - RISK FACTORS
- These won’t cause stomach ulcers but they may make them worse and more difficult to heal
- Smoking
- Drinking alcohol
- Have untreated stress
- Eat spicy foods
PEPTIC ULCER DISEASE - CLINICAL PRESENTATION
- Burning stomach px
o Most common symptom
o This is made worse by stomach acid or having an empty stomach - Feeling of fullness, bloating or belching
- Intolerance to fatty foods
- Heartburn
- Nausea
- Many people with peptic ulcers don’t have any symptoms
- But sometimes people may experience severe symptoms, such as
o Vomiting or vomiting blood – which appear red or black
o Dark blood in stools, or stools that are black or tarry
o Trouble breathing
o Feeling faint
o Nausea and vomiting
o Unexplained weight loss
o Appetite changes
PEPTIC ULCER DISEASE - PROGNOSIS
- Prognosis is excellent after the underlying cause is successfully treated
- Recurrence may be prevented by maintaining good hygiene and avoiding alcohol, smoking and NSAIDs
- Recurrence is common with rates exceeding 60% in most cases
DIVERTICULAR DISEASE - DEFINITION
- Diverticula are small, bulging pouches that can form in the lining of the digestive system
- Found most often in the colon
DIVERTICULAR DISEASE - CAUSE
- Diverticula usually develop when naturally weak placed in your colon give way under pressure
- This causes marble-sized pouches to protrude through the colon wall
- Diverticulitis occurs when diverticula tear, resulting in inflammation and in some cases infection
DIVERTICULAR DISEASE - POPULATION AFFECTED
Over 40s
DIVERTICULAR DISEASE - RISK FACTORS
- Aging
- Obesity
- Smoking
- Lack of exercise
- Diet high in animal fat and low in fibre
- Certain medications
o Steroids
o Opioids
o NSAIDs
DIVERTICULAR DISEASE - CLINICAL PRESENTATION
- Pain
o May be constant and persist for several days
o Lower left side of the abdomen is the usual site of px
o Sometimes the right side of the abdomen is more painful, especially in people of Asian descent - Nausea
- Vomiting
- Fever
- Abdominal tenderness
- Constipation
- Diarrhoea (less common)
DIVERTICULAR DISEASE - PROGNOSIS
- Treatment is
o Oral antibiotic, such as amoxicillin
o Rest
o Over the counter medicines for pain relief
o Low-fiber diet or liquid diet - Surgery is also an option
- Recurrence rate is about 20%
INFLAMMATORY BOWEL SYNDROME - DEFINITION
A common disorder that affects the stomach and intestines
INFLAMMATORY BOWEL SYNDROME - CAUSE
- Causes aren’t fully known
- Muscle contractions in the intestine
- Nervous system
o Poorly coordinated signals between the brain and intestines can cause your body to overreact to changes that typically occur in the digestive process - Severe infection
o Can develop after a severe bout of diarrhoea caused by bacteria or a virus
o May also be associated with a surplus of bacteria in the intestines - Early life stress
o People exposed to stressful events, especially in childhood, tend to have more symptoms of IBS - Changes in gut microbes
- Triggers
o Food
o Stress
INFLAMMATORY BOWEL SYNDROME - POPULATION AFFECTED
Females under 50
INFLAMMATORY BOWEL SYNDROME - RISK FACTORS
- Younger people
o Under 50 - Sex
o Women affected more than men - Have a family history of IBS
- Have anxiety, depression or other mental health issues
INFLAMMATORY BOWEL SYNDROME - CLINICAL PRESENTATION
- Symptoms vary but are usually present for a long time
- Abdominal px, cramping or bloating that is related to passing a bowel movement
- Changes in appearance of bowel movement
- Changes in how often you are having a bowel movement
- Diarrhoea
- Constipation
- Other symptoms include
o Sensation of incomplete evacuation
o Increased gas
o Mucus in the stool
INFLAMMATORY BOWEL SYNDROME - PROGNOSIS
- IBS does not shorten the lifespan of affected individuals or lead to major life-threatening complications in most patients
- Most serious symptoms can be avoided through a controlled diet and avoiding stressful
CROHN’S DISEASE - DEFINITION
Type of inflammatory bowel disease that causes inflammation of the tissues in your digestive tract
CROHN’S DISEASE - CAUSE
- Exact cause is unknown
- Previously diet and stress were suspected but now its known these aggravate but don’t cause
- Immune system
o Its possible a virus or bacterium may trigger Crohn’s
o But such a trigger is yet to be identified - Heredity
o More common in people who have family members with the disease so genes may play a role in making people more likely to have it
CROHN’S DISEASE - POPULATION AFFECTED
White people under 30
CROHN’S DISEASE - RISK FACTORS
- Age - More likely to develop the condition when you are young
o Before 30 - Ethnicity - White people are most likely
- Family history
- Smoking
- NSAIDs
CROHN’S DISEASE - CLINICAL PRESENTATION
- Symptoms can range from mild to severe
- They usually develop gradually and sometimes suddenly, without warning
- Diarrhoea
- Fever
- Fatigue
- Abdominal px and cramping
- Blood in stool
- Mouth sores
- Reduced appetite
- Weight loss
- Px or drainage near or around the anus due to inflammation from the tunnel into the skin
- People with severe Crohn’s disease may also experience symptoms outside of the intestinal tract
o Inflammation of the skin, eyes and jts
o Inflammation of the liver or bile ducts
o Kidney stones
o Iron deficiency (anaemia)
o Delayed growth or sexual development in children
CROHN’S DISEASE - PROGNOSIS
- Most people enjoy healthy active lives
- There isn’t a cure
- Treatments and lifestyle changes can help keep the disease in remission and prevent complications
- Lifestyle changes include changing diet
ULCERATIVE COLITIS - DEFINITION
Inflammatory bowel disease that causes inflammation and ulcers in your digestive tract
ULCERATIVE COLITIS - CAUSE
- Exact cause is unknown
- Previously diet and stress were thought to be the causes but they are now known to be aggravators rather than causes
- Immune system malfunction could be a cause
- Hereditary also seems to play a role
ULCERATIVE COLITIS - POPULATION AFFECTED
Adults before 30
ULCERATIVE COLITIS - RISK FACTORS
- Age - Usually before 30 but can be any age
- Race or ethnicity - White people at highest risk of developing
- Family history - Higher risk if you have a close relative, such as a parent, sibling or child with the disease
ULCERATIVE COLITIS - TYPES - ULCERATIVE PROCTITIS
o Inflammation is confined to the rectum
o Rectal bleeding may be the only sign of the disease
ULCERATIVE COLITIS - TYPES - PROCTOSIGMOIDITIS
o Inflammation involves the rectum and sigmoid colon
o Symptoms include
Bloody diarrhoea
Abdominal cramps and px
Inability to move bowels despite the urge to do so (tenesmus)
ULCERATIVE COLITIS - TYPES - LEFT-SIDED COLITIS
o Inflammation extends from the rectum up through the sigmoid and descending portions of the colon
o Symptoms include
Bloody diarrhoea
Abdominal cramping and px on the left side
Urgency to defecate
ULCERATIVE COLITIS - TYPES - PANCOLITIS
o Often affects the entire colon
o Symptoms include
Bloody diarrhoea that may be severe
Abdominal cramps and px
Fatigue
Significant weight loss
ULCERATIVE COLITIS - CLINICAL PRESENTATION
- Affects the innermost lining of the large intestine and rectum
- Symptoms can vary depending on severity of inflammation and where it occurs
- Diarrhoea
o Often with blood or pus - Rectal bleeding
- Abdominal px and cramping
- Rectal px
- Urgency to defecate
- Inability to defecate despite urgency
- Weight loss
- Fatigue
- Fever
- Failure to grow (in children)
ULCERATIVE COLITIS - PROGNOSIS
- No treatment
- Can treat the complications rather than the disease
- Around 10% get better after 1 attack
- More likely to have flareups throughout your life
- Some go weeks or years without any symptoms
- The longer the pt goes on without a flare the better their overall health will be
APPENDICITIS - DEFINITION
Inflammation of appendix
APPENDICITIS - CAUSE
- Blockage in lining of appendix resulting in infection
- Bacteria multiplies rapidly and become inflamed, swollen and filled with pus
APPENDICITIS - POPULATION AFFECTED
10 - 30 year olds
APPENDICITIS - RISK FACTORS
- Family Hx
- Male
- In children, Cystic Fibrosis inc risk
APPENDICITIS - CLINICAL PRESENTATION
- Sudden P that begins on right side of lower abdomen
- P that worsens if you cough, walk or make other jarring movements
- Nausea and vomiting
- Loss of appetite
- Constipation or diarrhoea
- Bloating
APPENDICITIS - PROGNOSIS
If not treated promptly, can rupture
PANCREATITIS - DEFINITION
- Inflammation of pancreas
- Tucked behind stomach in upper abdomen
- Acute or chronic
PANCREATITIS - CAUSE
- When digestive enzymes become activated while still in pancreas, irritating cells of pancreas causing inflammation
- Repeated bouts of acute pancreatitis can become chronic
- Poorly functioning pancreas can cause digestion problems and diabetes
- Conditions that lead to- gallstones, alcoholism, CF, infection, obesity, trauma
PANCREATITIS - POPULATION AFFECTED
- Can affect anyone, mostly commonly middle-aged and elderly people
- Men more likely to develop alcohol-related pancreatitis
- Women more likely to develop it from gallstones
PANCREATITIS - RISK FACTORS
- Excessive alcohol consumption
- Smoking
- Obesity
- Diabetes’s
- Family Hx
PANCREATITIS - CLINICAL PRESENTATION
- Upper abdominal P
- P radiation to back
- Tenderness in abdomen
- Fever
- Rapid pulse
- Nausea/vomiting
- Chronic- upper abdominal P, losing weight without trying, smelly stools
PANCREATITIS - PROGNOSIS
10-20 year survival rates estimated at 70%
LIVER CIRRHOSIS - DEFINITION
Late stage of scarring on liver caused by many forms of liver disease and conditions such as hepatitis and chronic alcoholism
LIVER CIRRHOSIS - CAUSE
- Chronic alcohol abuse
- Chronic viral hepatitis (B, C or D)
- Non-alcoholic fatty liver disease
- CF
- Poorly formed bile ducts
- Genetic digestive disorder (Alagille syndrome)
- Medication, including methotrexate or isoniazid
LIVER CIRRHOSIS - POPULATION AFFECTED
Alcoholics, people with viral hepatitis and people who are overweight
LIVER CIRRHOSIS - RISK FACTORS
- Drinking too much alcohol
- Overweight
- Viral hepatitis
LIVER CIRRHOSIS - CLINICAL PRESENTATION
- No signs or symptoms till extensive liver damage
- Easy bleeding or bruising
- Oedema
- Weight loos
- Spiderlike blood vessels on skin
- Redness in palms
- Loss of period, unrelated to menopause
- Confusion/drowsiness
- Nausea
LIVER CIRRHOSIS - PROGNOSIS
- Damage generally can’t be undone
- If diagnosed early and cause treated, further damage is limited
HEPATITIS A - DEFINITION
- Highly contagious infection
- Causes inflammation to liver, affecting its ability to function
HEPATITIS A - CAUSE
- Virus that affects liver cells inflammation
- Virus spreads when infected stool enters mouth to another person, e.g., through infected food/drink
- Drinking contaminated water
- Eating food washed in contaminated water
- Eating raw shellfish from sewage polluted water
- Having sexual contact with someone who has the virus
HEPATITIS A - POPULATION AFFECETD
- People who inject drugs
- Gay men
HEPATITIS A - RISK FACTORS
- Travel or work to areas where hep A is common
- Living with someone with hep A
- Sexual contact
- HIV +ve
- Recreational drugs
HEPATITIS A - CLINICAL PRESENTATION
- Appear after few weeks of virus infection
- Unusual tiredness and weakness
- Sudden nausea, vomiting and diarrhoea
- Clay or grey coloured stool
- Jt P
- Dark urine
- Jaundice (yellow skin/eyes)
HEPATITIS A - PROGNOSIS
- Does not cause long-term liver damage, doesn’t become chronic
- Can cause sudden loss of liver function, especially in older adults
HEPATITIS B - DEFINITION
- Tends to last less than six months
- Can become chronic
- Inc risk of developing liver failure, liver cancer or cirrhosis
HEPATITIS B - CAUSE
- Passed through blood, semen, or other bodily fluids
- Sexual contact
- Sharing of needles
- Mother to child
HEPATITIS B - POPULATION AFFECTED
Adults aged 30 - 60
HEPATITIS B - RISK FACTORS
- Having unprotected sex with someone who is infected
- Share needles during IV drug use
- Living with someone who has chronic HBV
- Infant born from infected mother
HEPATITIS B - CLINICAL PRESENTATION
- Abdominal P
- Dark urine
- Fever
- Jt P
- Loss of appetite
- Nausea and vomiting
- Weakness/fatigue
- Jaundice symptoms
HEPATITIS B - PROGNOSIS
- Most adults fully recover
- Infants/children likely to develop long-lasting hep B infection
- Vaccine prevents hep B
- No cure
HEPATITIS C - DEFINITION
Liver inflammation liver damage
HEPATITIS C - CAUSE
- Spreads when blood contaminated with virus enters bloodstream of uninfected person
- Exists in several distinct forms, known as genotypes
- Seven distinct HCV genotypes and more than 67 subtypes have been identified
HEPATITIS C - POPULATION AFFECTED
Males aged 35 - 45
HEPATITIS C - RISK FACTORS
- Health care worker exposed to infected blood
- Have HIV
- Piercing/tattoo from unclean enviro
- Mother to baby
HEPATITIS C - CLINICAL PRESENTATION
- Usual silent for many years, until liver damage is enough to cause signs and symptoms of liver damage
- Bleeding/bruising easily
- Fatigue
- Poor appetite
- Dark-coloured urine
- Oedema
- Weight loss
- Confusion/drowsiness
- Spiderlike blood vessels in skin
HEPATITIS C - PROGNOSIS
- Curable with oral medication taken everyday for 2-6 months
- Usually goes away undiagnosed
HEPATITIS D - DEFINITION
Can only get it if you have hep B
HEPATITIS D - CAUSE
- Exchange if infected blood or bodily fluid
- Can only infect you if you have hep B, hep D needs B strain to survive
- Happens in two ways
1. Co-infection- contract HBV and HDV at same time
2. Super-infection- become unwell with hep B then later develop hep D
HEPATITIS D - POPULATION AFFECTED
People with chronic Hepatitis B infection
HEPATITIS D - RISK FACTORS
- Having hep B
- Inject drugs
- Have sex with someone with hep B or D
- Have HIV and hep B
HEPATITIS D - CLINICAL PRESENTATION
- Jaundice
- Stomach upset
- P in belly
- Vomiting
- Fatigue
- Jt P
- Dark urine
- Light-coloured stool
- Symptoms may be worsened if you have hep B
HEPATITIS D - PROGNOSIS
- Can lead to lifelong liver damage and even death
- No cure yet, prescribe drugs to alleviate symptoms
HEPATITIS E - DEFINITION
Most common cause of acute hepatitis in UK
HEPATITIS E - CAUSE
- Consumption of raw or undercooked pork metal or offal, also with wild boar, venison and shellfish
- Through faeces
HEPATITIS E - POPULATION AFFECTED
- Pregnant women
- Immunosuppressed people
HEPATITIS E - RISK FACTORS
- Poor hygiene
- Drinking/eating from contaminated source
- Being pregnant
- Having a weakened immune system
- Having chronic liver disease
HEPATITIS E - CLINICAL PRESENTATION
- Mild fever
- Fatigue
- Reduced hunger
- Vomiting
- Belly P
- Dark urine
- Light-coloured faeces
HEPATITIS E - PROGNOSIS
- Generally mild and short-term (4-6 weeks)
- Does not require extra treatment
- Can be serious in people with weakened immune systems
- No vaccine, prevent by practicing good health and hygiene
ALCOHOLIC HEPATITIS - DEFINITION
Alcoholic hepatitis is inflammation of the liver caused by drinking alcohol.
ALCOHOLIC HEPATITIS - CAUSE
- Drinking excessive alcohol over many years
- Body’s process for breaking down chemicals produces highly toxic chemicals
- These chemicals trigger inflammation that destroys liver cells
- Over time, scars replace healthy liver tissue, interfering with functionality
- Cirrhosis is final stage of alcoholic liver disease
ALCOHOLIC HEPATITIS - POPULATION AFFECTED
People with a long history of alcohol abuse
ALCOHOLIC HEPATITIS - RISK FACTORS
- Women
- Obesity
- Genetics
- Binge drinking
ALCOHOLIC HEPATITIS - CLINICAL PRESENTATION
- Rarely causes symptoms
- Can cause sudden jaundice and liver failure in some people
- Loss of appetite
- Nausea/vomiting
- Abdominal tenderness
ALCOHOLIC HEPATITIS - PROGNOSIS
- Reduced alcohol consumption to allow liver recovery
- Risk of developing cirrhosis, liver failure, cancer
AUTOIMMUNE HEPATITIS - DEFINITION
- Types
1. Type 1- can occur at any age, common to have other autoimmune disorder
2. Type 2- most common in adults and young people
AUTOIMMUNE HEPATITIS - CAUSE
- When immune system attacks liver
- Can lead to chronic inflammation and serious damage to liver cells
- Believed to be interaction of genes controlling immune system function and exposure to viruses and drugs
AUTOIMMUNE HEPATITIS - POPULATION AFFECTED
Females of any age and race
AUTOIMMUNE HEPATITIS - RISK FACTORS
- Female
- Hx of certain infections
- Hereditary
- Having autoimmune disease
AUTOIMMUNE HEPATITIS - CLINICAL PRESENTATION
- Variable symptoms
- Fatigue
- Jaundice
- Enlarged liver
- Abnormal blood vessels on the skin
- Skin rashes
- Jt P
- Loss of menstrual periods
AUTOIMMUNE HEPATITIS - PROGNOSIS
Majority achieve remission and 10 year survival rate is around 94%
REVIEW SIGNS AND SYMPTOMS OF GU DISEASE
- Frequent UTIs
- Pain in pelvic/groin area
- Bladder incontinence
- P or discomfort whilst urinating
- Blood in urine
- Bad or strong-smelling urine
- Reduced urine output
- Visually abnormal or malformed genitals
UTI - DEFINITION
- Infection in any part of urinary system
- Kidneys, ureters, bladder and urethra
- Most involve lower urinary tract (bladder and urethra)
UTI - CAUSE
- When bacteria enter urinary tract through urethra and begins to spread to bladder
- Infection of bladder- Escherichia coli (E.coli), commonly found in GI tract, sometimes other bacteria can cause. Having sex can lead to bladder infection. In women, urethra being closest to anus, which makes it easier for bacteria to travel to bladder
- Infection of urethra- happens when Gi bacteria spreads from anus to urethra,
UTI - POPULATION AFFECTED
Women with diabetes
UTI - RISK FACTORS
- Female anatomy
- Sexual activity + new sexual partners
- Certain type of birth control + spermicidal agents
- Menopause- post-menopause cases decline in circulating oestrogen changes urinary tract, inc risk of UTI
UTI - CLINICAL PRESENTATION
- Strong urge to urinate that doesn’t go away
- Burning sensation when urinating
- Urinating often
- Urine appears red, bright pink or brown- signs of blood in urine
- Strong-smelling urine
- Pelvic P in women- especially in centre of pelvis and around pubic bone
UTI - CLINICAL PRESENTATION - KIDNEYS
- Back or side P
- High fever
- Shaking and chills
- Nausea/vomiting
UTI - CLINICAL PRESENTATION - BLADDER
- Pelvic pressure
- Lower belly discomfort
- Frequent, painful urination
- Blood in urine
UTI - CLINICAL PRESENTATION - URETHRA
- Burning with urination
- Discharge
UTI - PROGNOSIS
- Serious problems can result if UTI spreads to kidneys
- Often treated with ABs
OVERRACTIVE BLADDER - DEFINITION
Causes frequent and sudden urge to urinate that may be difficult to control
OVERRACTIVE BLADDER - CAUSE
- Occurs when bladder starts to contract on their own even when the volume of urine in bladder is low, called involuntary contractions, create urgent need to urinate
- Neurological disorders- e.g., strokes, MS
- UTI can cause similar symptoms
- Hormonal changes during menopause
- Conditions affecting bladder, such as tumours or bladder stones
- Factors that get in the way or urine leaving bladder, e.g., enlarge prostates, constipation or previous surgery to treat incontinence
OVERRACTIVE BLADDER - POPULATION AFFECTED
OVERRACTIVE BLADDER - RISK FACTORS
- Advancing age- higher risk of conditions which can interfere with excretion
- Cognitive decline- e.g., from stroke
- Bowel control problems
OVERRACTIVE BLADDER - CLINICAL PRESENTATION
- Feel a sudden urge to urinate that is difficult to control
- Unintentional loss of urine immediately after an urgent need to urinate
- Urinate frequently, usually eight or more times in 24 hours
- Wake up more than two times in night to urinate
OVERRACTIVE BLADDER - PROGNOSIS
Can be managed with dietary changes, time voiding and bladder-holding techniques using pelvic floor muscles
INTERSTITIAL CYSTITIS - DEFINITION
- Chronic condition causing bladder pressure, P and pelvic P
- Mild severe P
- Signals get mixed up in relation to when bladder is full and needs to excrete urine, leading to more frequent urination and smaller volumes of urine
INTERSTITIAL CYSTITIS - CAUSE
- Unknown
- Factors that influence:
o Defect to epithelium of bladder- leak may allow toxic substances in urine to irritate bladder wall
o Autoimmune reaction
o Hereditary
o Infection or allergy
INTERSTITIAL CYSTITIS - POPULATION AFFECTED
Women over 30
INTERSTITIAL CYSTITIS - RISK FACTORS
- Women
- 30+
- Having chronic P disorder- e.g., IBS or fibromyalgia
INTERSTITIAL CYSTITIS - CLINICAL PRESENTATION
- Variable
- Gradual progression
- Flare ups triggered by menstruation, sitting for too long, stress, exercise, and sexual activity
- P in pelvis or between vagina and anus in women
- P between scrotum and anus in men
- Chronic pelvic P
- Persistent, urgent need to urinate
- P or discomfort while bladder fills and relief after urinating
- P during sex
INTERSTITIAL CYSTITIS - PROGNOSIS
- Can have long lasting effects on QOL
- No cure, but medication and therapies to relieve
