Lower GI problems Flashcards
Primary causes of diarrhea
infectious organisms –> usually viruses (can be bc of PPIs)
Cdif is almost always hospital aquired –> (can be bc of broad spectrum antibiotics)
Diarrhea: upper GI, lower GI, CDI
upper: large volume watery stools
lower: small volume bloody diarrhea (fever)
CDI: colitis and intestinal perforation
When shouldn’t you give antidiarrheals?
for infectious diarrhea –> you won’t get the infection out
use antibiotics instead
How to treat cdif
wash hands - no sanitizer
oral vancomycin or fidaxomicin for 10 days
stop nonessential meds
if recurrent: fecal transplant
Which drugs cause constipation and why is constipation an issue?
opioids cause it –> take narcotics with stool softeners
obstruction leads to perforation
Acute abdominal pain
Medical emergency
-could be organ damage, obstruction, bleeding, perfortation, peritonitis
**give pregnancy test, then probably x-ray
abdominal trauma
can be blunt or perforating –> blunt is usually worse
often messes up liver or spleen
Concerns: shock, peritonitis, abdominal compartment syndrome (fucks with repiration and cardiac/kidney func)
IBS
chronic abdominal pain or discomfort along with weird bowel patterns
-no known cause, but phychological stuff impacts it
IBS-C = women
IBS-D = men
Appendicitis
fecalith obstructs lumen of appendix leading to distention, venous engorement, mucu/bacteria buildup, gangrene, perforation, peritonitis
Manifestations of appendicitis
pain at McBurney’s point esp with coughing/sneezing
jump on right foot or lie still with right leg flexed
How to treat appendicitis
immediate surgery to avoid rupture and peritonitis
Preop: IV fluid/pain meds; NPO, antiemetics
Peritonitis: primary vs secondary
primary = blood borne organisms
secondary = perforation of organs that spill contents into peritoneal cavity
complications of peritonitis
hypovolemic shock, sepsis, intraabdominal abscess, paralytic ileus, ARDS
Treatment of peritonitis
-may or may not require surgery
-IV for fluid and antibiotics
-analgesia and knees flexed for pain
-rest and sedatives for anxiety
-monitor VS, I/O, and O2
-antiemetic
-NPO!!! NG tube if needed
Gastroenteris
inflammation of stomach and small intestine
often from viruses in food
you don’t really do much - it goes away on its own
IBD
Inflammation of GI tract with sporadic periods of remision and exacerbation –> autoimmune
2 types:
Ulcerative colitis = colon
Crohn’s disease = anywhere- mouth to anus
Treat with steroids
Triggers for IBD
-diet, smoking, and stress which alter flora
-high sugar or fat intake
-low fruit, veggie, omega-3, or fiber
-NSAIDs, antibiotics, oral contraceptives
-genetic factors
Characteristics of Crohn’s
-ulcers, strictures, leaks, abscesses, fistulas
-weight loss
-pain
-fever
-diarrhea/cramping
-rectal bleeding
