T. Upper Gastrointestinal Problems Flashcards
Nausea
- A feeling of discomfort in the epigastrium with a conscious desire to vomit
- Usually occurs before vomiting
- Related to slowing of gastric motility and emptying
Vomiting
- The forceful ejection of partially digested food and secretions (emesis) from the upper gastrointestinal (GI) tract
- closure of pyloris, closure of glottis, deep inspiration, relaxation of stomach ad contraction of abs
Chemoreceptor trigger zone (CTZ)
area of the medulla oblongata that receives inputs from blood-borne drugs or hormones, and communicates with other structures in the vomiting center to initiate vomiting.
Regurgitation
partially digested food that’s brought up from stomach
Projectile vomiting
real propulsive expulsion of stomach contents, no nausea associated with it. Very quickly comes out
Antiemetics
Drug that act on CNS in CTZ to block chemicals that trigger nausea and vomiting.
Foodborne Illness
• Nonspecific term that describes acute GI symptoms such as nausea, vomiting, diarrhea, and colicky abdominal pain caused by the intake of contaminated food.
Two main types
Acute gastro-enteritis from bacteria
Neurological symptoms from botulism
Escherichia coli O157:H7 Poisoning
- Causes hemorrhagic colitis and kidney failure
- Found primarily in undercooked meats, particularly poultry and hamburger
- Treatment involves supportive care to maintain blood volume.
Hemorrhagic colitis is an illness characterized by crampy abdominal pain, initial watery diarrhea, and subsequent development of grossly bloody diarrhea with little or no feve
Oral Cancer
- may occur on the lips or anywhere within the mouth (e.g., tongue, floor of the mouth, buccal mucosa, hard palate, soft palate, pharyngeal walls, tonsils).
- Get rid of pre-exsisting factors: tabacco (chew/pipe), smoking, oral hygine
- symptoms: ulcers, hardness, thickening, pain
Gastro-esophageal Reflux Disease (GERD)
caused by reflux of gastric contents up into the lower esophagus causing irritation, inflammation, even erosion of esophagus
Avoid factors that cause reflux: • Smoking cessation • Elevating head of bed 30 degrees • Avoid lying down 2–3 hours after eating. • Avoid late-night eating.
Antacids
neutralize stomach acid
H2 receptor blockers
- Reduce amount of acid made in stomach
* Histamine H2-receptor antagonists
Proton Pump Inhibitors
Block acid production and heal the esophagus
Hiatal Hernia
Herniation of a portion of the stomach into the esophagus through an opening, or hiatus, in the diaphragm
Hiatus = opening in diaphragm hernia = gap in this muscular wall that allows the contents inside the abdomen to protrude outward.
Sliding hiatal hernia
stomach sludes into thoracic cavity when supine then goes back into abdomen when upright
Para-esophageal (rolling) hiatal hernia
esophageal junction is in place but the fundus and greater curvature of stomach roll up through diaphragm. Acute episode=medical emergency cause it’s getting pinched
Esophageal Cancer
- Majority of tumours are located in middle and lower portions of esophagus.
- usually appears as ulcerated lesion.
- may penetrate muscular layer and outside wall of esophagus.
Esophageal Diverticuli
- Sac-like outpouchings of one or more layers of esophagus
- 3 kinds
Diverticula are small, bulging pouches that can form in the lining of your digestive system
Zenker’s diverticulum
- a condition characterized by a pouch that develops in the upper esophagus in the neck.
- Most common location
Traction diverticulum
Near esophageal midpoint
Epiphrenic diverticulum
Above the LES (lower esophageal sphincter)
Esophageal Strictures
- a narrowing or tightening of the esophagus that causes swallowing difficulties.
- Causes include: GERD, Ingestion of strong acids or alkalis, Trauma
Achlasia
- Peristalsis of lower two-thirds of esophagus absent
- Impairment of neurons that innervate esophagus
- Unopposed contraction of LES
- Incomplete relaxation of LES
- Obstruction occurs at/near diaphragm
- Food and fluid accumulate in lower esophagus
- Result: dilation of lower esophagus
Halitosis
Foul odor emanating from the mouth.
• symptom of Achlasia
