Lecture 7.5: GI Disorders Flashcards
What are the swallowing disorders?
5th, 9th or 10th cranial nerve damage (chewing/swallowing/gag)
Poliomyelitis (polio causes paralysis)
Encephalitis
Myasthenia Gravis (facial weakness)
Botulism (tetany)
Deep anesthesia
Why does encephalitis cause swallowing issues?
Damaging swallowing center in the brainstem.
Why do patients under deep anesthesia have difficulty swallowing?
They are not paralyzed, so ingestion of food will cause vomiting.
What is achalasia?
Lower esophageal sphincter is unable to relax during swallowing.
What causes achalasia?
Damage to the myenteric plexus in the lower 2/3 of the esophagus
What are the symptoms of achalasia?
Esophageal enlargement
Ulceration
Food fails to pass into stomach from esophagus :(
What is gastritis?
Inflammation of gastric mucosa
What happens if gastritis is deep?
Atrophy of the gastic mucosa.
What can cause gastritis?
Chronic bacterial infection of the gastric mucosa, treated by ABX therapy.
Alcohol and aspirin damage the protective barrier, irritating the more fragile mucosa.
What are the 5 causes of peptic ulcers?
High acid/peptic content
Irritation
Poor blood supply
Poor mucus secretion
H. pylori infection
What are the 2 main causes of peptic ulcers?
Excess secretion of acid and pepsin by gastric mucosa.
Diminished ability of the barrier to protect the stomach against its digestive enzymes.
How does H. pylori cause peptic ulcers?
Breaks down the barrier and stimulates gastric acid secretion.
What can cause abnormal digestion in the SI via the pancreas?
Pancreatitis due to excessive alcohol consumption.
Gallstones blocking pancreatic duct
What can cause malabsorption by the SI mucosa?
Sprue (both tropical and non-tropical)
What is the difference between tropical and non-tropical sprue?
Non-tropical refers to gluten-free diet
Tropical means it can be treated with tetracycline and folic acid.
What are the names of non-tropical sprue?
Idiopathic sprue
Celiac Disease
Gluten enteropathy
What is the pathophys of celiac disease?
Immune response causes microvilli
This destroys/blunts the microvilli, impairing absorption.
Note:
Removing wheat/rye will allow the microvilli to regrow within weeks.
Is celiac diease from a pathogen or inherited?
Inherited disease.
First-degree relative = 1 in 10 risk
What are the symptoms of a tropical sprue?
Diarrhea
Fatty stool (it will float probs)
Indigestion
Cramps
Weight loss and malnutrition
Fatigue
What are the physiological effects of malabsorption?
Severe nutritional deficiency
Body wasting
Demineralization of bones
Inadequate blood coagulation (vit K)
Anemia (B12)
What is enteritis?
Inflammation of the intestinal tract.
What happens in enteritis?
Irritated mucosa
Increased secretions
Increased motility
What is cholera?
Disease that causes severe diarrhea and dehydration within hours.
What causes cholera?
Contaminated water and food from feces containing Vibrio cholerae
Insufficiently cooked seafood
What are the risk factors for cholera?
Poor sanitation
Lack of clean drinking water
Poverty :(
What is ulcerative colitis?
Inflammation of the colon, causing ulcerations.
What happens in ulcerative colitis?
Repeated diarrhea
Eventual ileostomy may be required (bag from the ileum to bypass the colon)
OR
Removal of the entire colon :(
What causes ulcerative colitis?
Unknown.
Strong hereditary tendencies though!
