upper GI disorders Flashcards by Hope Holbrook

upper GI consists of…

esophagus
stomach
beginning of small intestines

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upper GI problems

esophageal disorders —> GERD, hiatal hernial
inflammatory disorders of the stomach —> gastritis, acute gastroenteritis, PUD

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common causes of dysphagia

mechanical obstruction –> stenosis or stricture, diverticula, tumors

neuromuscular dysfunction –> CVA, achalasia (LES can’t open properly)

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who is most likely to experience dysphagia?

intubated & trach patients

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GERD

back flow of gastric acid from the stomach into esophagus

open LES leads to stomach conten (highly acidic) coming back up

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causes of GERD

~anything that alters closure strength of LES or increases abdominal pressure~

ex:
-fatty, spicy, tomato-based, & citrus foods
-caffiene
-large amt of alcohol
-smoking
-sleep position
-obesity
-pregnancy
-meds

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clinical manifestations of GERD

heartburn (pyrosis) ***
dyspepsia (indigestion)
regurgitation
chest pain
dysphagia
pulmonary symptoms

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other S/S of GERD

mouth- tooth decay, gingivitis, bad breath
chest- chronic cough, worsening asthma, recurrent PNA’s
abdomen- bloating, belching
ears- earache
throat- hoarseness, chronic sore throat, throat clearing, laryngitis, lump in throat, post nasal drip

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complications of GERD

ulcers
scarring
strictures
BARRETTs ESOPHAGUS*

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Barrett’s esophagus

development of abnormal metaplastic tissue - premalignant
*3-fold increased risk of developing adenocarcinoma of the esophagus (esophageal cancer)
*survival only 17%

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hiatal hernia

a defect in the diaphragm that allows part of the stomach to pass into thorax

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2 types of hiatal hernia

sliding hernia: small, no treatment
paraesophageal hernia: part of stomach pushes through diaphragm and stays there

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causes of hiatal hernia

*exact cause is unknown

-age-related (older)
-injury or other damage may wearing diaphragm muscle
-repeatedly putting too much pressure on the muscles around the stomach (severe coughing, vomiting, constipation and straining to have BM)

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clinical manifestations of hiatal hernia

asymptomatic

belching
dysphagia
chest or epigastric pain

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T/F: GERD and hiatal hernia are common to coexist

TRUE

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risk factors for hiatal hernia

age (older)
obesity
smoking

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acute gastritis

temporary inflammation of stomach lining only – lasts 2-10 days

*intestines NOT affected

causes of acute gastritis

irritating substances (alc)
drugs (NSAIDs)
infectious agents (H. pylori)

considerations with NSAIDs

block prostaglandin synthesis
*prostaglandins stimulate secretion of mucus in stomach (protective coating)

chronic gastritis

progressive disorder with chronic inflammation in stomach — lasts weeks to years

complications of chronic gastritis

PUD, bleeding ulcers, anemia, gastric cancers

2 main causes of chronic gastritis

autoimmune – attacks parietal cells
H. pylori infection

what is H. pylori?

helicobacter pylori bacterium lives in acidic environment

destructive pattern of persistent inflammation –> can cause chronic gastritis, PUD, and stomach cancer

how is H. pylori transmitted?

person to person via saliva, fecal matter, or vomit
contaminated food or water

clinical manifestations of ACUTE/CHRONIC gastritis

~sometimes none~ anorexia (loss of appetite) N/V postprandial discomfort (stomach pain after eating) intestinal gas hematemesis (blood in vomit) tarry stools (black) anemia stomach burning

acute gastroenteritis

inflammation of stomach AND small intestine

cause of acute gastroenteritis

viral infections: norovirus and rotavirus bacterial infections: E. coli, salmonella, campylobacter parasitic infections

clinical manifestations of acute gastroenteritis

watery diarrhea (if bacterial, blood) abd pain N/V fever, malaise generally last 1-3 days - can last as long as 10 days

complications of acute gastroenteritis

FVD

peptic ulcer disease

ulcerative disorder of the upper GI tract --> esophageal, stomach (gastric ulcer), duodenum (peptic ulcer) develops when GI tract is exposed to acid and H. pylori

agressive factors in GI tract

H. pylori NSAIDs acid pepsin (digestive enzyme in stomach) smoking

defensive factors in GI tract

mucus bicarbonate blood flow prostaglandins (stimulate release of mucus)

cause of PUD

H. pylori injury causing substances --> NSAIDs, ASA, alcohol excess secretion of acid smoking fam hx

stress and PUD

stress worsens gastric ulcers but does not cause increased gastric acid secreted with the stress response

risk factors of PUD

age higher doses of NSAIDs hx of PUD use of corticosteroids and anticoagulants serious systemic disorders H. pylori infection

patho of PUD

1. mucosa is damaged 2. histamine is secreted --> increases acid and pepsin secretion --> causes further tissue damage; + vasodilation --> causes edema 3. if blood vessels are destroyed, this results in bleeding

PUD: duodenal ulcer

most common type age: any; early adulthood

PUD: gastric/peptic ulcer

age: peak 50-70 result of an increased use of NSAIDs, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

PUD: clinical manifestations

sometimes none N/V, anorexia, weight loss, bleeding, burning pain (middle of abd that is usually worse when stomach is empty)

characteristics of a gastric + duodenal ulcer

burning, cramping, gas-like located: epigastrium (upper abd), back timing: gastric --> 1-2 hours after eating duodenal --> 2-4 hours after eating

characteristics of duodenal ulcer

burning, cramping, gas-like (same as gastric)