Lecture 7.5: GI Disorders

Question 1

What are the swallowing disorders?

Answer 1

5th, 9th or 10th cranial nerve damage (chewing/swallowing/gag)

Poliomyelitis (polio causes paralysis)
Encephalitis
Myasthenia Gravis (facial weakness)
Botulism (tetany)
Deep anesthesia

Question 2

Why does encephalitis cause swallowing issues?

Answer 2

Damaging swallowing center in the brainstem.

Question 3

Why do patients under deep anesthesia have difficulty swallowing?

Answer 3

They are not paralyzed, so ingestion of food will cause vomiting.

Question 4

What is achalasia?

Answer 4

Lower esophageal sphincter is unable to relax during swallowing.

Question 5

What causes achalasia?

Answer 5

Damage to the myenteric plexus in the lower 2/3 of the esophagus

Question 6

What are the symptoms of achalasia?

Answer 6

Esophageal enlargement
Ulceration
Food fails to pass into stomach from esophagus :(

Question 7

What is gastritis?

Answer 7

Inflammation of gastric mucosa

Question 8

What happens if gastritis is deep?

Answer 8

Atrophy of the gastric mucosa.

Question 9

What can cause gastritis?

Answer 9

Chronic bacterial infection of the gastric mucosa, treated by ABX therapy.

Alcohol and aspirin damage the protective barrier, irritating the more fragile mucosa.

Question 10

What are the 5 causes of peptic ulcers?

Answer 10

High acid/peptic content
Irritation
Poor blood supply
Poor mucus secretion
H. pylori infection

Question 11

What are the 2 main causes of peptic ulcers?

Answer 11

Excess secretion of acid and pepsin by gastric mucosa.

Diminished ability of the barrier to protect the stomach against its digestive enzymes.

Question 12

How does H. pylori cause peptic ulcers?

Answer 12

Breaks down the barrier and stimulates gastric acid secretion.

Question 13

What can cause abnormal digestion in the SI via the pancreas?

Answer 13

Pancreatitis due to excessive alcohol consumption.
Gallstones blocking pancreatic duct

Question 14

What can cause malabsorption by the SI mucosa?

Answer 14

Sprue (both tropical and non-tropical)

Question 15

What is the difference between tropical and non-tropical sprue?

Answer 15

Non-tropical refers to gluten-free diet
Tropical means it can be treated with tetracycline and folic acid.

Question 16

What are the names of non-tropical sprue?

Answer 16

Idiopathic sprue
Celiac Disease
Gluten enteropathy

Question 17

What is the pathophys of celiac disease?

Answer 17

Immune response attacks microvilli
This destroys/blunts the microvilli, impairing absorption.

Note:
Removing wheat/rye will allow the microvilli to regrow within weeks.

Question 18

Is celiac disease from a pathogen or inherited?

Answer 18

Inherited disease.

First-degree relative = 1 in 10 risk

Question 19

What are the symptoms of a tropical sprue?

Answer 19

Diarrhea
Fatty stool (it will float probs)
Indigestion
Cramps
Weight loss and malnutrition
Fatigue

Question 20

What are the physiological effects of malabsorption?

Answer 20

Severe nutritional deficiency
Body wasting
Demineralization of bones
Inadequate blood coagulation (vit K)
Anemia (B12)

Question 21

What is enteritis?

Answer 21

Inflammation of the intestinal tract.

Question 22

What happens in enteritis?

Answer 22

Irritated mucosa
Increased secretions
Increased motility

Question 23

What is cholera?

Answer 23

Disease that causes severe diarrhea and dehydration within hours.

Question 24

What causes cholera?

Answer 24

Contaminated water and food from feces containing Vibrio cholerae

Insufficiently cooked seafood

Question 25

What are the risk factors for cholera?

Answer 25

Poor sanitation
Lack of clean drinking water
Poverty :(

Question 26

What is ulcerative colitis?

Answer 26

Inflammation of the colon, causing ulcerations.

Question 27

What happens in ulcerative colitis?

Answer 27

Repeated diarrhea

Eventual ileostomy may be required (bag from the ileum to bypass the colon)

OR

Removal of the entire colon :(

Question 28

What causes ulcerative colitis?

Answer 28

Unknown.
Strong hereditary tendencies though!