GI System/esophagus/stomach

Question 1

What is a hiatal hernia?

Answer 1

Protrusion of the stomach upward through the diaphragm or displacement of the stomach and gastroesophageal junction upward into the thorax
-May be congenital or acquired
-Symptoms include heartburn from GERD
-Conservative or symptomatic treatment is the same as for GERD. Surgery may be indicated

Question 2

Femoral hernia?

Answer 2

Causes lateral pelvic wall pain and groin pain

Question 3

Inguinal hernia?

Answer 3

Causes groin pain

Question 4

Peptic ulcers?

Answer 4

Ulcerative lesions that occur in the upper GI tract in areas exposed to acid-pepsin secretions. Can affect all or one layer of the stomach or duodenum.
-Caused by H pylori infection, aspirin or NSAIDs excessive secretions of gastric acids, stress or heredity.
Symptoms: epigastric pain (cramping, gnawing, or burning)-COFFEE GROUND EMESIS
-Complications can include circulatory shock or bleeding**
-AGGRAVATED by change in position and RELIEVED by food or antacids
**Presents as radiating back pain or refers to the R shoulder

Question 5

Duodenal ulcer?

Answer 5

MELENA (BLACK TARRY) STOOLS

Question 6

What two diagnoses make up irritable bowel disease?

Answer 6

Ulcerative colitis and chrons disease
-IBD symptoms are abdominal pain, frequent attacks of diarrhea, fecal urgency and weight loss
-Red flags: joint pain (reactive arthritis), skin rashes can occur. P! In low back. Complications can include intestinal obstruction and corticosteroid toxicity (low bone density, increased fracture risk)
-Intestinal absorption is disrupted and nutritional deficiencies are common
-Chronic IBD can lead to anxiety and depression

Question 7

What is ulcerative colitis?

Answer 7

-Only the large intestine and the rectum
-Results in inflammation of the bowel and is characterized by remissions and exacerbations
-Symptoms: rectal pain, bleeding, bloody diarrhea with mucus/pus**, fecal urgency, weight loss LBP
LLQ pain
-SKIP LESIONS ARE ABSENT

Question 8

What is Chron’s disease?

Answer 8

-Occurs anywhere in the GI tract
-skip lesions**
-Symptoms: pain relieved by passing gas, abdominal pain, weight loss, joint arthritis
RLQ pain

Question 9

What is GERD?

Answer 9

Reflux backward movement of gastric contents of stomach into esophagus producing heartburn
-Failure of LOWER ESOPHAGEAL SPHINCTER to regulate flow of food FROM esophagus into the stomach and ^ gastric pressure
-Acidic gastric fluids (pH <4) damage the esophagus producing reflux esophagitis
-Heartburn occurs 30-60 mins after eating and at PM during laying down

Question 10

What are the PT interventions for GERD?

Answer 10

-Positional changes: avoid complete supine position and modify or sleep with head elevated
-Avoid jogging or jumping that exacerbate symptoms
-Avoid large meals and certain foods
-Antacids (tums), acid-suppressing proton pump inhibitors (PPI’s) (Prilosec), H2 blockers

Question 11

What is Gastritis?

Answer 11

Inflammation of the stomach mucosa, can be acute or chronic
-Caused by severe burns, aspirin or other NSAIDs, corticosteroids, food allergies, viral or bacterial infections
-Hemorrhagic bleeding can occur
-Symptoms: N/V, anorexia and pain
-Occurs with certain diseases such as peptic ulcer, bacterial infection caused by H. Pylori, stomach cancer, pernicious anemia, Addison’s disease, thyroid disease

Question 12

What is the treatment for gastritis?

Answer 12

-H2 blockers, antacids, PPI’s and avoiding caffeine, nicotine and alcohol

Question 13

What is malabsorption syndrome?

Answer 13

-A complex of disorders characterized by problems in intestinal absorption of nutrients (fat, carbs, proteins, vitamins, calcium and iron)
-Can be caused by gastric or small bowel resection (SHORT-GUT SYNDROME) or a # of different diseases
-Can also be caused by NSAIDs

Question 14

What are the symptoms of malabsorption syndrome?

Answer 14

-anorexia, weight loss, abdominal bloating, pain and cramps, indigestion, steorrhea (abnormal amounts of fat in feces). Diarrhea can be explosive or chronic
-Can produce iron deficiency anemia and easy bruising and bleeding due to lack of vitamin K
-Muscle weakness and fatigue 2’ lack of protein, iron, folic acid, and vitamin B
-Bone loss, pain, and predisposition to develop fractures from lack of calcium, phosphate and vitamin D
-Neuropathy
-muscle spasms
-peripheral edema

Question 15

What is diverticular disease?

Answer 15

-Pouch like herniations of mucosal layer of colon through muscularis layer
-Diverticulitis/diverticulosis

Question 16

What is diverticulosis?

Answer 16

-pouchlike herniations of the colon, especially the sigmoid colon
-Symptoms are MINIMAL but can includes rectal bleeding
-Dietary factors including the lack of dietary fiber, lack of physical activity, and poor bowel habits
-Can lead to diverticulitis

Question 17

What is diverticulitis?

Answer 17

-Inflammation of 1 or more diverticula
-Fecal matter penetrates diverticula and causes inflammation and abscess
-Symptoms include pain and cramping in the LLQ, N/V, slight fever and ^ WBC
-Complications: bowel obstruction, perforation with peritonitis, and hemorrhage
-Red flag: back pain
-Treatment: exercise