Unit 7 Screening for Gastrointestinal Disease

Question 1

What are the S/S of GI Disorders?

Answer 1

• Dysphagia (Difficulty swallowing)
• Odynophagia (Pain during swallowing
• GI Bleeding
• Epigastric P! with radiation to the back
• Constipation
• Diarrhea
• Fecal incontinence
• Early satiety with weight loss

Sx may also be affected by food

Question 2

With the S/S of GI disorders, what are the different types of GI Bleeding?

Answer 2

• Coffee-Ground Emesis
  –Vomit with blood and gastric acid. (Ulcers)
• Bright red blood
  –Colon, Rectum, and Anus Lesions (Distal parts of GI)
• Melena (Dark Tary stools)
  –Stomach/Duodenum Ulcers
• Reddish or Mahogany-Colored Stools
  –Medicatons or foods (beets)

Question 3

With Abdominal Pain referral , what structures refer pain to the Epigastric (T3-T5)?

Answer 3

Heart, esophagus, stomach, duodenum, gallbladder, liver or pancreus

Question 4

With Abdominal Pain referral , what structures refer pain to the Periumbilical (T9-T11)?

Answer 4

Pancreas, small intestine, appendix or proximal colon

Question 5

With Abdominal Pain referral , what structures refer pain to the Hypogastrum (T10-L2)?

Answer 5

Large Intestine, Colon, bladder, or uterus

Question 6

What is Gastroesophageal Reflux Disease (GERD)?

Answer 6

This is the backward movement of stomach acids and other stomach contents, such as pepsin and bile, into the esophagus, a phenomenon called acid reflux

Question 7

What are Typical symptoms for GERD?

Answer 7

• Heartburn
• Regurgitation with bitter taste in mouth
• Belching

Question 8

What is Peptic Ulcer?

What are Gastric and duodenal ulcers caused by?

Answer 8

A loss of tissue lining the lower esophagus, stomach, and duodenum

Gastric and Duodenal ulcers are caused by infection with Helicobacter Pylori (a corkscrew-shaped bacterium) and chronic use of NSAIDs

Question 9

What are the Clinical S/S of Peptic Ulcer?

What are the s/s of Gastric and Duodenal ulcers?

Answer 9

• “Heartburn” or epigastric pain
• Radiating back pain, stomach pain
• Right shoulder pain
• Bloody stools, Black, Tarry stools

Gastric: aggravated by food
Duodenal: Releived by food, mild, antacids, or vomiting

Question 10

What is Appendicitis?

Answer 10

An inflammation of the Verminiform appendix that occurs most commonly in adolescents and yound adults.
- When the appendix becomes obstructed, inflamed, infected, and infected, rupture may occur which leads to peritonitis

This usually requires surgery

Question 11

What are the Clinical S/S for Appendicitis?

Answer 11

• (+) McBurney’s Point and/or (+) Pinch-an-inch test
• Positive Hop Test
• Periumbilical and/or epigastric pain; RLQ or flank pain; RIght thigh, groin, or testicular pain
• Abnormal involuntary muscle guarding and rigidity
• Nausa Vomiting and anorexia

Question 12

What is the purpose of Rebound Tenderness or Blumberg’s Sign?

Answer 12

To assess for appendicitis or generalized peritonitis; Press your fingers gently but deeply over the RLQ for 15 to 30 seconds. The hand is then quickly removed.

Question 13

What is Crohn’s Disease?

What is Ulcerative Colitis?

Answer 13

An inflammatory disease that most commonly attacks the terminal end (or distal portion) of the small intestine (ileum) and the colon due to an abnormal reaction by the body’s immune system

Ulcerative Colitis is an inflammation and ulceration of the inner lining of the large intestine (colon) and rectum

Question 14

What are the S/S of both Crohn’s Disease and Ulcerative Colitis?

Answer 14

• Night sweats
• Arthritis, Migratory arthralgias
• Hip pain (Iliopsoas abscess)

Question 15

What is Diverticlits?

Answer 15

This is an infection and inflammation that accompany a micoperforation of one of the diverticula

Normal Diverticula

Diverticulosis is very common, whereas complications results in diverticulits

Question 16

What are the S/S for Diverticulits?

Answer 16

• Generalized abdominal pain often with loss of appetite, nausa, abdominal bleeding
• (L)LQ pain; Possible (+) Pinch-Test
• Decreased or absent bowel sounds; Palpable abdominal mass

Question 17

What is Pancreatitis?

Answer 17

An inflammation of the pancreas due to anatomic or functional disorders, autoimmune conditions, Chronic Alcohol Consumption (90% of cases).

Question 18

What are Acute S/S of Pancreatitis?

Answer 18

- Epigastric pain radiating to the back
- Nausea, vomiting, diarrhea; anorexia
- Fever and sweating, tachycardia
- Malaise, weakness and jaundice

Question 19

What are Chronic S/S of Pancreatitis?

Answer 19

-Upper Left Lumbar Region Pain
- Weight loss
- Oily or fatty stools and clay-colored or pale stools

Question 20

What is Irritable Bowl Syndrome (IBS)?

Answer 20

A functional disorder of mobility of the small and larger intestines. Most common GI problem (50% of GI referrals). Linked to psychological issues

Question 21

What are the S/S of IBS?

Answer 21

• Painful abdominal cramps
• Constipation
• Diarrhea
• Anorexia
• Bad Breath
• Nausea and Vomiting

Question 22

Psoas abscess originating from GI Disorders

What can cause Obturator or Psoas Abscess?

Answer 22

The iliopsoas is not separated from the abdominal or pelvic cavity

• Any infectious or inflammatory process present in either of these cavities can seed itself to the psoas muscle by direct extension

Question 23

What are the Clinical S/S of Obturator or Psoas Abscess?

Answer 23

• Fever (“hectic” fever pattern: up and down)
• Night sweats
• Antalgic gait
• Back, pelvic, abdominal, hip and/ or knee pain
• Palpable, tender mass

Question 24

What are the Guidelines for Immediate Medical Attention for GI Disorders?

Answer 24

• Anytime Appendicitis or Iliopsoas/Obturator abscess is suspected {(+) McBurny’s Test, (+) Iliopsoas, (+) for Rebound Tenderness}
• Any time the therapist suspects Retroperitoeal bleeding form an injured, damaged, or ruptured spleen, (+) Kehr’s sign, or Ectopic Pregnancy; or there is a history of trauma; Missed menses

Question 25

What is an Ectopic Pregnancy?

Answer 25

This is when the egg attaches itself somewhere outside the uterus, usually to the inside of a fallopian tube

Question 26

What are the S/S for Ectopic Pregnancy?

Answer 26

• Severe abdominal or pelvic pain accompanied by vaginal bleeding
• Extreme lightheadedness or fainting
• Diarrhea and vomiting
• Shoulder pain

Question 27

What are the Guidelines for Physician Referral?

Answer 27

• Pt. who chronically rely on laxatives should be encouraged to discuss bowel management w/o drugs
• Joint involvement accompanied by skin or eye lesions may be reflective of Inflammatory bowel disease and should be reported to the physician if they are unaware
• Back Pain associated with meals or relieved by a bowl movement or back pain abdominal pain at the same level requires mediacal evaluation
• Back pain of unknown cause that does not fit a MSK pattern, especiallly in a person with a previous history of cancer.