LO1-2 Pathophysiology of GI Disorders Flashcards
Peristalsis
propel food bolus toward the stomach without involvement of brain stem
Portal vein
transports venous blood from the GI tract directly to the liver for processing of nutrients that have been absorbed
The cardiac sphincter
controls the amount of food that moves back up the esophagus
Chyme
the materials that exit through the pyloric sphincter
Duodenum
the portion of the small intestine that begins the absorption of nutrients and where the pancreas, liver and gallbladder connect to digestive system
Stomach absorbs
water, fat soluble substances
Alcohol is absorbed
rapidly in small intestine
primary role of the large intestine
is to complete the reabsorption of water
Abdominal disorders can result from
inflammation, infection, and obstruction
Gastroesophageal reflux
occurs when acid, normally localized to
the stomach, enters the esophagus
Other causes of gastroesophageal reflux are:
- Nicotine
- Fried or fatty foods
- Chocolate
- Coffee
- Citrus fruits and juices
- Peppermints
- Pregnancy
Esophagitis
Esophagitis is the irritation and inflammation of the esophagus caused by stomach acids and
digestive enzymes repeatedly refluxing up from the stomach
Esophagitis Signs and Symptoms
•Burning sensation in chest
•Pain when swallowing
•Dysphagia (caused by the narrowing of lower esophagus due to scarring resulting in food
sticking in the area)
•Bleeding if ulcers develop (noted by black stools, anemia and vomiting blood)
Gastritis
Gastritis is an acute or chronic inflammation of the gastric mucosa caused by an increase gastric
acid secretion.
Gastritis is often associated with alcohol ingestion, drugs, and stress.
Esophageal Varices
what is it
signs and symptoms
treatment
Condition: hemorrhagic
Pain, bright red blood, Melena, shock
Common with hepatic disease and often result from portal hypertension caused by cirrhosis of the liver
Tachy, hypotension, pale cool clammy skin
Give fluid to map of 65
Check peripheral pulses
Airway issues
Bowel Obstruction
what is it
signs and symptoms
treatment
Signs include
- abdominal pain and fullness.
- Rigidity usually all over
- Look pregnant
- Diarrhea initially
- Constipation may eventually result.
- Nausea and vomiting are common in later stages
- Extreme cases have feculent breath
Management
- watch for sepsis
- Fluid resuscitation can be useful
- Needs fluid even if map is good
Peptic Ulcer Disease
Protective layer of the stomach and small intestine erode allowing the acid to eat into the lining of the stomach
Condition: Acute inflammation
Pain, often relieved by food intake, bleeding
Upper GI bleed
Mouth, stomach, esophagus
Condition: hemorrhagic
Pain, hemorrhage
Upper GI bleeding: The upper GI tract is located between the mouth and the upper part of the small intestine.
Mallory-Weis Syndrome
the oesophageal lining tears during severe vomiting and may lead to severe haemorrhage and sepsis
Perforated ulcer
when it eats all the way through the stomach
Cholecystitis
what is it
signs and symptoms
treatment
-Gall stones, gall bladder attack
Obstruction of the cystic duct leading from the gallbladder to the duodenum, Inflammation of the gallbladder; usually by gallstones
Fever, jaundice, tachycardia
Gallbladder is in right upper under liver
Pain radiates to right shoulder
ALS for pain med
Give Zofran
Give IV for n/v meds
cholecystjts Risk factors
Risk factors Females Pregnant Older people Caucasians Overweight or recent extreme weight loss
Cirrhosis
what is it
signs and symptoms
- Cirrhosis is the final phase of chronic liver disease.
- irreversible scarring of the liver resulting in poor liver function.
Signs and symptoms
- Edema and ascites (fluid from the peritoneal cavity)
- Jaundice
- Itching
- Gallstones
- Medication sensitivity
- Toxicity
Hepatitis
what is it
signs and symptoms
- Infectious
- Inflammation and damage of the liver
- Associated with the sudden onset of malaise, weakness, anorexia, intermittent nausea and vomiting, and dull RUQ pain
hepatitis cause
treatment
- Causes
o Viral(Hep A,B,C-in Canada D,E,F,G)
A and E: transmitted through fecal matter
B,C and D transmitted through contact typically sexual
o Epstein Barr virus
o Bacterial Infections
o Liver Cancer - Pain meds from ALS
- IV yes
- O2 based on signs and symptoms of shock
o Nasal cannula for n/v pts
Pancreatitis
what is it
signs and symptoms
- Pancreas creates enzymes that we use to digest our food
o Creates insulin - In the area of the epigastric
- Some common contributing factors to pancreatitis are an increase in alcohol consumption and Gallstones
- More prevalent in the male population
- Can also be caused by certain medications, trauma, cancer
Signs and Symptoms
- Nausea and Vomiting
- Sharp, Epigastric or RUQ pain that can radiate to back
- Possible fever, tachycardia, hypotension, possible muscle spasms in extremities
- Grey turner sign: bruising to flanks
- Cullen sing: bruising around umbilical region
Appendicitis
what is it
signs and symptoms
- Caused by an accumulation of material, usually feces.
- Lower right
- Obstruction of normal flushing
- Ripe condition for bacterial reproduction
- Can result in ultimate rupture, peritonitis ( generalized abdominal pain), sepsis, and death
Signs and Symptoms
- Periumbilical pain that migrates to RLQ
- Duration is usually less than 48 hours
- As the condition progresses the pain will change characteristics and locations
- Guarding
- Rebound tenderness (parietal pain): doesn’t hurt when you push but when you let go it hurts
Diverticulitis
what is it
signs and symptoms
- Is caused typically by a decrease in fiber intake
- Consistency of stool become more solid
- Hard stools take more contractions
- Small defects in colonic wall fail
- Diverticula: Feces become trapped in these pouches
- Fistula: abnormal connection between two cavities and are typically found between colon and bladder
- Can occur anywhere in the colon but most common in LLQ
Signs and Symptoms - Abdominal pain
- Tends to be localized to the left side of the lower abdomen
- Classic signs of infection
- Fever, malaise, body aches, chills, nausea, and vomiting
Crohn’s Disease:
- May affect the entire GI tract
- Immune system attacks the GI tract.
- Most likely site of inflammation is the ileum.
- Scarred, narrow, stiff, and weakened portion of the small intestine
Ulcerative Colitis
what is it
signs and symptoms
Caused by o Generalized inflammation of the colon o Chronic inflammation o Thinning of the wall of the intestine o Weakened, dilated colon prone to infections by bacteria and bleeding o Most common second decade of life
- Signs and Symptoms
o Bloody diarrhea
o Abd pain (mild to severe)
Lower GI bleeding
- The lower GI tract is located between the upper part of the small intestine and the anus. The lower GI tract includes the small and large bowels.
- Intestinal Bleeding Causes – Polyps, ulcers, diverticulitis, tumors, radiation therapy
- Rectroanal Area bleeding – Hemorrhoids resulting from straining
Hemorrhoids
- Swelling and inflammation of blood vessels surrounding the rectum
- Common problem
- Increased pressure on the rectum
- Irritation of the rectum
Bowel Obstruction
- Presentation Varies according to the underlying cause
- Signs include abdominal pain and fullness.
o Rigidity usually all over
o Look pregnant - Diarrhea initially
- Constipation may eventually result.
- Nausea and vomiting are common in later stages
- Extreme cases have feculent breath
- Hematochezia
bright red bleeding
- Hyperperistalsis
- Hypoperistalsis
- Hyperperistalsis: Increased activity in the bowel
- Hypoperistalsis: decreased bowel sounds
- Absent bowel sounds
mean no sounds for 2 mins
- Biliary pain
commonly radiates around the right side of the back and angle of the scapula
- Pancreatic pain
goes straight through the epigastrium to the back in the midline
- Blood/puss under the diaphragm
may present as pain in the top of the shoulder
- A leaking or ruptured aneurism
causing abdominal pain and back pain which may radiate to upper thighs
- Uterine and rectal pain
will present in suprapubic area, lower back or both
Visceral pain
- Hollow organs
- Difficult to localize: described as burning, cramping, gnawing or aching usually felt superficially
- Cause: organ contracts too forcefully or is distended (stretched)
Parietal pain/ rebound pain
- Peritoneum
- Steady, achy pain, more easy to localize than visceral, pain increases with movement
- Causes: inflammation of the peritoneum
Somatic pain
- Peripheral nerve tracts
- Well localized pain usually felt deeply
- inflammation or injury to tissue, causing activation of peripheral nerve tracts
Referred pain
- peripheral nerve tracts
- pain originating in the abdomen and causes pain in distant locations; similar paths for the peripheral nerves of the abdomen and the distant location
- causes: usually occurs after an initial visceral, parietal or somatic pain
