lower GI disorders Flashcards
lower GI disorders
appendicitis
peritonitis
irritable bowel syndrome (IBS)
inflammatory bowel disorder (IBD): Crohn’s, ulcerative colitis
diverticulosis/diverticulitis
causes of appendicitis
appendix is obstructed –> leads to inflammation
complications of appendicitis
gangrene
abscess formation
peritonitis
pain and appendicitis
classic pain: RLQ in periumbilical area
rebound pain: severe pain after release of palpating hand over RLQ
sudden pain relief: may indicate rupture/peritonitis
clinical manifestation of appendicitis
begins as dull, steady pain in periumbilical area –> progresses over 4-6 hours & localizes to RLQ
*low grade fever
*Nausea
*anorexia
diagnosis appendicitis
clinical s/s
increase WBC
abd ultrasound/sonogram
exploratory laparotomy
ultrasound is used to get sonogram (pic ultrasound takes)
peritonitis
inflammation of the peritoneum (serous membrane that lines abd cavity and covers visceral organs
what happens to the peritoneum if you have peritonitis?
inflammation
fluid shifts –> 3rd spacing –> can lead to hypovolemic shock and sepsis
decreased peristalsis
can lead to paralytic ileum and intestinal obstruction
causes of peritonitis
perforated ulcer
pancreatitis
ruptured gallbladder
ruptured spleen
ruptured bladder
ruptured appendix
clinical manifestations of peritonitis
usually sudden and severe (can’t move/talk)
abdominal pain
tenderness
N/V
rigid board-like abd
fever, elevated WBC, increased HR, decreased BP
treatment of peritonitis
difficult
treat with anti-inflammatories
treat underlying cause likely results in decreasing inflammation of the peritoneum
IBS
chronic condition characterized by alterations in bowl pattern d/t changes in intestinal motility *chronic and frequent constipation (IBSC)
*chronic and frequent diarrhea (IBSD)
IBS symptoms
vary by individual
-abd distention, fullness, flatus, and bloating
-intermittent abd pain exacerbated by stress and relieved by defecation
-bowel urgency
-intolerance to certain foods (sorbitol, lactose, gluten)
-stool with mucous (no blood)
psychosocial stress and IBS
emotional stress does not cause IBS
IBS can cause stress/psychological problems
IBS can be made worse by stress
cause of IBS
unknown but thought to be triggered by stress, food, hormone changes, GI infections, menstrual cycles
IBD
crohns and ulcerative colitis
chronic inflammation of the intestines
exacerbations and remissions
IBD is more common in…
women
caucasians
jews
smokers
cause of IBD
genetically autoimmune activated by an infection
patho of crohn’s disease
lymph structures of the GI tract are blocked –> tissue becomes engorged and inflamed –> deep linear fissures and ulcers develop in a patchy pattern in the bowel wall
*skip lesions
*cobblestone appearance
complications of crohn’s disease
malnutrition (anemia)
scar tissue and obstructions
fistulas - connection between 2 things that shouldn’t be connected
cancer
clinical manifestations of crohn’s disease
crampy lower abd pain (RLQ)
watery diarrhea
palpable abd mass (RLQ)
mouth ulcers
s/s of fistulas
systemic:
weight loss, fatigue, no appetite, fever, malabsorption of nutrients
ulcerative colitis
inflammation of the mucosa of the RECTUM and COLON
usually develops in the 3rd decade of life
more common in white people of European descent (ashkenazi jewish descent) – occasionally in black, rare in asians
patho of ulcerative colitis
- inflammation begins in rectum and extends in a continuous segment that may involve ENTIRE colon 2. leads to large ulcerations
- necrosis of epithelial tissue can result abscesses (CRYPT abscesses)
- colon + rectum try to repair the damage with granulation tissue
why is the colon and rectum repairing damage with the granulation tissue a problem?
tissue is fragile and bleeds easily
