Module 11 Gastrointestinal Flashcards
Peritonitis
- Inflammation of peritoneal cavity
Peritoneal Cavity
- Forms lining of abdominal cavity
- Can be impacted by GI tract disease
Ascites
- Peritoneal cavity fills with fluid
Digestion
- Breaking down food components
- Enzymes/acids
- Mainly in stomach & duodenum
Absorption
- Taking up nutrients & water
- Nutrients occurs in small bowel
- Water/electrolyte occurs in large bowel
Excretion
- Expelling waste from digestion process
Common Signs/Symptoms
- Depend on cause
- Dependant on severity
- Pain
- Nausea/vomit
- Loss of appetite
- Diarrhea
- Constipation
- Distension
- Fatigue
- Fever
- Bleeding
GI Bleeding
- Can be acute or a cancer sign
- Characterization based on symptoms
Hematemesis
- Vomit as result of internal bleeding
- Effects stomach acid on hemoglobin
- Coffee ground like emesis (dark)
Hematochezia
- Fresh blood (red) in stool
- Commonly lower GI bleed
Melena
- Dark black stool
- Digestion of blood
- Commonly upper GI bleed
Occult GI Bleed
- Not visible
- Identified on stool screening test/bloodwork
Appendicitis
- Inflammation of appendix
- Associated with fecalith (hard stool)
- Ischemia
- Ulceration
- Secondary infection
Appendicitis Risk Factors
- Extremes of age
- Family history
- Males more common
Appendicitis Signs/Symptoms
- Abdominal pain (RLQ)
- Rebound tenderness
- Nausea/vomit
- Fever
Appendicitis Complications
- Appendiceal rupture (perforation)
- Peri-appendiceal abscess
- Peritonitis
Appendicitis Treatment
- Surgical removal
Helicobacter Pylori (H. Pylori)
- Gram neg bacteria
- Colonizes in stomach
- Increasing prevalence in developing countries
H.Pylori Signs/Symptoms
- Often asymptomatic
- Abdominal pain (mid/upper)
- Nausea
- Bloating
H.Pylori Complications
- Peptic/duodenal ulcers
- Bleeding & perforation
- Chronic inflammation
- Increase risk of lymphoma & cancer
H.Pylori Diagnosis
- Endoscopy
- Biopsies
- Blood work
- Urea breath test
H.Pylori Treatment
- Triple therapy (antibiotics & protein pump inhibitors)
Inflammatory Bowel Disease (IBD)
- Unknown etiology
- Inflammation of bowel
- Onset 15-35 years
IBD Symptoms
- Diarrhea (blood)
- Urgency
- Abdominal pain
- Fever
- Weight loss
- Fatigue
- Extraintestinal problems
Crohn’s Disease
- Ileum & colon (patchy involvement)
- Uncommon hematochezia
- Transmural inflammation
Crohn’s Disease Complications
- Abscesses
- Strictures
- Fistulas
- Perianal disease
Ulcerative Colitis
- Rectum (continuous involvement)
- Limited to colorectum
- Common hematochezia
- Increase colon cancer risk
- Superficial inflammation
Treatment Crohn’s/Ulcerative
- Anti-inflammatory meds
- Symptom relief for stool
- Nutritional support
- Surveillance endoscopy
Crohn’s Surgery
- Removal of damaged sections
- Management of abscesses/fistulas
Ulcerative Colitis Surgery
- Remove colon/rectum
Diverticulum
- Outpouching of bowel wall
Diverticulum Disease
- Presence of diverticula
- Most common sigmoid colon in north america
Diverticulum Causes
- Increased luminal pressure (low fiber, high fat)
- Weak points in gut wall
Diverticulitis
- Inflammation of diverticula
Diverticulitis Symptoms
- Fever
- Worsening of abdominal pain (LLQ)
Diverticulitis Complications
- Abscess formation
- Perforations
- Strictures
- Fistulas
Diverticulitis Treatment
- Antibiotics
- Surgery
Bowel Obstruction
- Blockage prevents passage of foods/liquids
Bowel Obstruction Signs/Symptoms
- Abdominal distension
- Vomiting
- Constipation
GI Herniation
- Pouch like protrusion of peritoneum
GI Adhesions
- Fibrosis/scar tissue
- Between loops of bowel
Volvulus
- Twisting of bowel on itself
- Mesentery
Intussusception
- Telescoping of bowel into adjacent segment
Colorectal Cancer
- Third most diagnosed cancer in Canada
- Adenocarcinoma most common type
Colorectal Cancer Staging
- Stage 1/2 confined to bowel
- Stage 3 metastasis to local lymph nodes
- Stage 4 metastasis to distant organs/sites
Colorectal Cancer Pathogenesis
- Mutations in bowel mucosa can cause pre-cancerous lesions
- Polyps (not all result in cancer mutation)
- Local invasion/metastasis
Colorectal Cancer Symptoms
- Rectal/stool bleed
- Change in bowel habits
- Abdominal discomfort
- Weakness
- Fatigue
- Weight loss
Colorectal Cancer Risk Factors
- Family history
- Age
- Inflammatory bowel disease
- Diet
- Smoking
- Obesity
- Exercise
Colorectal Cancer Screening
- Primary preventions/early detection reduces mortality
- Fecal immunochemical test (FIT)
- Stool test (blood)
- Endoscopy (directly examine bowel)
Esophageal Cancer
- Presents at advanced stage
- Less common than colorectal
- Adenocarcinoma most common in Canada
- Distal third of esophagus
Esophageal Adenocarcinoma Pathogenesis
- Background of chronic gastroesophageal reflux disease
- Mucosa undergoes intestinal metaplasia
- Greater risk of dysplasia & malignancy
Esophageal Adenocarcinoma Symptoms
- Pain/difficulty swallowing (dysphagia)
- Weight loss
- Chest pain
- Vomiting
Esophageal Adenocarcinoma Risk Factors
- GERD (gastroesophageal reflux disease)
- Tobacco use
- Obesity
- Radiation
