Upper GI Disorders Flashcards
Upper GI
Esophagus
Stomach
Beginning of small Intestines
Lower GI
Small intestines
Colon
Large Intestines
Rectum/Anus
Dysphagia Definition
Difficulty swallowing
-Begins with solids and progresses to liquids
Common Causes of Dysphagia
- Mechanical obstruction
- Stenosis
- Diverticula
- Tumors - Neuromuscular dysfunction
- CVA (stroke)
- Achalasia (LES can’t open properly)
LES
Lower Esophageal Sphincter
GERD is a problem with the…
Lower Esophageal Sphincter (LES)
-
GERD Etiology
Anything that alters closure strength of LES or increases abdominal pressure
GERD Foods + Irritating Factors
Fatty foods Spicy foods Tomato based Citrus Caffeine Excess alcohol Cigarettes Sleep Position Obesity Pregnancy Certain drugs
GERD: Manifestations
Pyrosis (heartburn) Dyspepsia (indigestion or pain in stomach) Regurgitation Chest pain Dysphagia Pulmonary symptoms
Other GERD Manifestations
Mouth
- tooth decay
- gingivitis
- bad breath
Chest
- Chronic cough
- Worsening asthma
- Recurrent PNA
Abdomen
- Bloating
- Belching
Ears
-Earache
Throat
- Hoarseness
- chronic sore throat
- Throat clearing
- Laryngitis
- Lump in throat
- Post nasal drip
GERD Complications
Ulcerations
Scarring
Strictures
Barret’s esophagus
Barrett’s
Development of abnormal Metaplastic tissue
- 3x risk for adenocarcinoma
- Overall survival only 17%
Upper GI: Hiatal Hernia
Defect in diaphragm that allows part of the STOMACH to pass into the THORAX
2 types of Hiatal Hernia
- Sliding Hernia- usually small and often no treatment needed
- Paraoesophageal- part of stomach pushes through the diaphragm and stays there
Hiatal Hernia: Patho (Causes)
-Exact Cause unknown
-Age related
-Obesity
-Injury or other damage may weaken the diaphragm
-Repeatedly putting to much pressure on the muscles around the stomach
+Severe coughing
+Vomiting
+Constipation and straining
HH: Symptoms
- Asymptomatic
- Belching
- Dysphagia
- Chest or epigastric pain
HH Risk Factors
Age
Obesity
Smoking
HH treatment
MOSTLY CONSERVATIVE
- small, freq meals, avoid laying after meal
- avoid tight clothing and abd supports
- Weight control for obesity
- Antacids for GERD
- Surgery if Bad
Inflammatory disorders of the stomach
Gastritis
Acute Gastroenteritis
PUD
Acute Gastritis
TEMPORARY inflammation of stomach lining (Intestines NOT affected)
Acute Gastritis Etiology
Lasts 2-10 days
- Irritating substances (alcohol)
- Drugs (NSAIDS)
- Infectious Agents
- H. pylori most common
Chronic Gastritis (2 main etiologies)
Progressive disorder with chronic inflammation in the stomach
2 Main etiologies
- Autoimmune
- attacks parietal cells - chronic H. Pylori infection
How long does chronic gastritis last?
Weeks to years
Chronic Gastritis Complications
PUD Bleeding Ulcers Anemia Gastric Cancers
H. pylori
Helicobacter pylori
(gram -, spiral)
-acidic environment
-Destructive pattern of persistent inflammation
How is H. pylori transmitted?
- person to person via saliva, fecal matter, or vomit
2. Contaminated food or water
Acute + Chronic Gastritis Symptoms
None Anorexia N/V (w/ or w/o blood) Postprandial discomfort (after meals) Intestinal gas Hematemesis (vomiting blood) Tarry or black stools Anemia
Acute Gastroenteritis
Inflammation of stomach AND intestine
Acute Gastroenteritis: Etiology
Viral Infections: norovirus + rotavirus
Bacterial Infections: E. Coli, salmonella, campylobacter
Parasitic infections
Acute Gastroenteritis: How long does it last?
Usually 1-3 days but may last as long as 10 days
Acute Gastroenteritis: Symptoms
Watery Diarrhea -bloody if bacterial Abdominal Pain N/V Fever, malaise
Acute Gastroenteritis: Major complication
Fluid volume deficits
Peptic Ulcer Disease
Ulcerative disorder of upper GI tract
- Esophageal
- Stomach (gastric ulcers)
- Duodenum (peptic ulcer in first part of small intestine)
PUD is from?
when GI tract is exposed to acid + H. pylori
GI health Balancing Act: Aggressive Factors
H. pylori NSAIDS Acid Pepsin Smoking
GI health Balancing Act: Defensive Factors
Mucus
Bicarbonate
Blood flow
Prostaglandins
PUD: Etiology (What factors cause it?)
- H. pylori
- Injury Causing Substances
- NSAIDS, ASA, Alcohol - Excessive secretion of acid
- Smoking
- Family Hx
- Stress (increases acid secretion)
PUD: Risk Factors
- Age
- Higher doses of NSAIDs
- Hx of PUD
- Corticosteroids + Anti coags
- Serious systemic disorders (autoimmune)
- H. Pylori infection
PUD pathogenesis
Mucosa is damaged
Histamine is secreted:
-Inc Acid + Pepsin secretion causes further tissue damage
-Vasodilation (edema)
If blood vessels are destroyed, this results in BLEEDING
PUD Classification: Duodenal Ulcer
- Most common
- Any age, early adulthood
PUD Classification: Gastric/Peptic Ulcer
-What age and why this age?
Age: 50-70
WHY This Age?
-Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious system illnesses
PUD Clinical Manifestations
Sometimes none N/V, Anorexia Weight loss Bleeding Burning pain (in middle of abdomen that is usually worse when stomach is EMPTY)
PUD: Gastric Ulcer Pain
Characteristics: Burning, cramping, gas-like
Location: Epigastrium, back
Timing: 1-2 hours after eating
PUD: Duodenal Pain
Characteristics: Burning, cramping, gas-like
Location: Epigastrium, back
Timing: 2-4 hours after eating
PUD Complications
“HOP”
Hemorrhage
Obstruction
Perforation + Peritonitis
