Screening for GI Disorders Flashcards
The important relationship between the GI system and immune system.
Significant amount of immune system function occurs in the GI system. Estimated 70% of immune system is found in the gut
Emerging evidence on GI and nervous system
Gut microbiota may be important in interactions between intestine and brain
Referral sites for GI disorders
Sternal region Shoulder Neck Scapular region Mid T/S Lumbar region Hip Pelvis Sacrum
The most common intra-abdominal disorders that refer pain to the musculoskeletal system are…
those that involve ulceration or inflammation of the mucosal lining of the GI tract
What is a huge problem causing GI pain?
Many patients use medications associated with GI distress. Also, they use medications to suppress the symptoms associated with GI distress
What medications are associated with GI distress?
Aspirin
NSAIDs
Cardiovascular medications
Steroids
Medications used to suppress symptoms associated with GI distress
Antacids
Histamine-2 inhibitor
Proton pump inhibitors
What different types of things cause general GI symptoms?
Food Alcohol Drugs Emotions/stress Disease
Clinically relevant signs and symptoms of GI disorders
Abdominal pain Dysphagia or odynophagia GI bleeding Symptoms altered by food Early satiety Constipation Diarrhea Arthralgia Shoulder pain Obturator or psoas abscess
Reasons for abdominal pain
Inflammation
Distention/obstruction
Necrosis/ischemia
What can be inflammed in the GI disorder that can cause abdominal pain?
Visceral or parietal peritoneum
Describe the abdominal pain associated with inflammation
Steady, deep, and boring
Poorly localized if visceral peritoneum
Localized if parietal peritoneum
Visceral nociceptors are susceptible to…
Stretch or tension
Example of distention/obstruction leading to abdominal pain
Bowel obstruction
Describe the abdominal pain associated with distention/obstruction
May be described as “colicky pain” and patients may have difficulty finding a comfortable position
Necrosis/ischemia can be a source of…
visceral pain
Describe the abdominal pain associated with necrosis/ischemia
Steady pain which is usually intense with no relief from analgesic medication
Why does visceral abdominal pain occur in midline?
Due to embryological development in the midline and the tissues receive bilateral innervation from the spinal cord
Why is visceral abdominal pain poorly localized?
Because the tissue is innervated via multiple segments of the spinal cord, spanning up to 8 spinal levels
Regions primarily associated with pain due to GI organs
Epigastric
Periumbilical
Hypogastrium
Sympathetic nerve distribution of the epigastric region
T3-T5
Sympathetic nerve distribution of the periumbilical region
T9-T11
Sympathetic nerve distribution of the hypogastrium
T10-L2
Organs causing epigastric pain
Heart, esophagus, stomach, duodenum, gall bladder, liver, and pancreas
Organs causing periumbilical pain
Pancreas, small intestine, appendix, and proximal colon
Organs causing hypogastrium pain
Large intestine, colon, bladder, and uterus
What may be the first indication of visceral disease?
Sudomotor changes
