Lower G.I. problems Flashcards
appendicitis
Inflammation of appendix
cause of appendicitis
apPendix is obstructed leads to inflammation
complications of appendicitis
Gangrene
Abscess formation
Peritonitis
s/sx of appendicitis
Classic pain-RLQ in Periumbilical area
rebound pain/tenderness – severe
Sudden pain relief
dull steady pain, 4 to 6 hours – localizes RLQ
Fever, nausea, anorexia
what does sudden pain Relief in appendicitis indicate
May indicate rupture
what is the peak incidence time for appendicitis?
10 to 12 years old
diagnosis of appendicitis
Increase WBC
Abdominal sonogram
Exploratory lap
peritonitis
Inflammation of peritoneum
Serous membrane that lines abdominal cavity, and covers visceral organs
what occurs from the fluid shift of peritonitis?
Hypovolemic shock, sepsis
Paralytic ileus, intestinal obstruction
causes of peritonitis
Perforated ulcer, pancreatitis
Ruptured gallbladder, spleen, bladder, appendix
s/sx appendicitis
sudden and severe
abdominal pain, tenderness
Rigid, board like abdomen
N/V
Fever, increased WBC
increased heart rate
Decreased blood pressure
What is a key indicator of appendicitis?
Hard, rigid abdomen
Irritable bowel syndrome – IBS
chronic condition
Alterations in bowel pattern due to changes in intestinal motility
Chronic and frequent constipation and diarrhea – IBSC, IBSD
s/sx IBS
vary by individual
Abdominal distention, fullness, bloating
Intermittent, abdominal pain
bowel urgency
Intolerance to sorbitol, lactose, gluten
Non-bloody stool – excess mucus
how is abdominal pain in IBS exacerbated?
stress
how is abdominal pain in IBS relieved?
Defecation
t/f emotional stress can exacerbate IBS
True
t/f IBS cannot cause, psychological stress and problems
False
Cause of IBS
generally unknown**
Can be triggered by stress, food, hormone changes, GI infections, menses-women
Inflammatory bowel disease – IBD
Group of life-changing, chronic illnesses
Chronic inflammation of intestines
Who is inflammatory bowel disease more common in
Women
Caucasians
Jewish descent
Smokers
cause of IBD
Autoimmune activated by infection
Crohn’s disease Patho
Lymph structures of G.I. tract are blocked
tissue becomes engorged an inflamed
Deep linear, fissures and ulcers develop in a Patchy pattern in the bowel wall
what are the fissures in ulcers that develop in a Patchy pattern
skip lesions
Cobblestone appearance
Complications of Crohn’s disease
malnutrition
Anemia
Scar tissue/obstruction
Fistulas
Cancer
s/sx Crohn’s disease
Crampy lower abdominal pain – RLQ
Watery diarrhea
Systemic: weight, loss, fatigue, no appetite, fever, malabsorption of nutrients
Palpable, abdominal mass RLQ
Mouth ulcers
ulcerative colitis
Inflammation of mucosa of rectum, and colon
Who is ulcerative colitis more common in
Third decade of life
Caucasian
European descent
Ashkenazy, Jewish
Occasionally African-Americans
Who is ulcerative colitis rare in?
Asians
Patho of ulcerative colitis
Inflammation begins in rectum and extends in a continuous segment that may involve entire colon
Leads to large ulcerations
Necrosis of epithelial tissue – crypt abscess
Colon and rectum Try to repair damage with new granulation tissue– tissue is fragile and bleeds easily
s/sx ulcerative colitis
Abdominal pain
Bloody diarrhea
Systemic: weight loss, decreased appetite, fever
complications of ulcerative colitis
Hemorrhage
Perforation
Cancer
Malnutrition
Anemia
Strictures
what does ulcerative colitis put patients at risk for?
Fissures
Abscesses
Toxic megacolon
Colorectal carcinoma
Liver disease
PH/fluid and electrolyte imbalance
VTE, DVT
diverticulosis Patho
development of diverticula
Small pouches in lining of Colon that bulge outward through weak spots
t/f diverticulosis can be congenital, but not acquired
False, can be both
Cause of diverticulosis
Low fiber diet with chronic constipation
Where does diverticulosis occur?
Descending colon
does diverticulosis involve inflammation?
No
s/sx diverticulosis
Usually asymptomatic
Discovered accidentally with presentation of acute diverticulitis
diverticulitis
Inflammation of one or more diverticula from retained fecal material
s/sx diverticulitis
LLQ abdominal pain
Fever, increased WBC
constipation, diarrhea
Acute passage, large quantity of Frank blood
can diverticulitis resolve spontaneously?
Yes
complications of diverticulitis
Perforation
Obstruction
Peritonitis