Upper GI Disorders Flashcards
Upper GI problems are composed of what organs? (3)
esophagus
stomach
BEGINNING of small intestines
Lower GI problems are composed of what organs? (3)
small intestines
colon (large intestines)
rectum/anus
What are the esophageal disorders? (2)
GERD (Gastroesophageal reflux disease)
Hiatal Hernia
What are the inflammatory disorders of the stomach? (3)
Gastritis
Acute Gastroenteritis
PUD (peptic ulcer disease)
Dysphagia: Definition
difficulty swallowing
(begins with solids and progresses to liquids)
Dysphagia: Causes
- Mechanical obstruction
Stenosis or stricture
Diverticula (w/in esophagus)
Tumors - Neuromuscular dysfunction
CVA
Achalasia (LES can’t open properly
People with trachs or that were intubated (can get better)
GERD: Definition
AKA “heartburn”
Backflow of gastric acid from the stomach into the esophagus
Occurs via the lower esophageal sphincter (LES): doesn’t close properly
Highly acidic material
GERD: Etiology
Anything that alters closure strength of LES
OR
increases abdominal pressure
GERD: Etiology Examples (11)
fatty foods
spicy foods
tomato based foods
citrus foods
caffeine
large amounts of alcohol
cigarette smoking
sleep position
obesity
pregnancy
pharmacologic agents
GERD: Clinical Manifestations (CM) (6)
heartburn (pyrosis)
dyspepsia
regurgitation
chest pain
dysphagia
pulmonary symptoms
GERD: Mouth CM (3)
tooth decay
gingivitis
bad breath
GERD: Ears CM (1)
earache
GERD: Chest CM (3)
chronic cough
worsening asthma
recurrent pneumonias
GERD: Throat CM (6)
hoarseness
chronic sore throat
throat clearing
laryngitis
lump in throat
post nasal drip
GERD: Complications
ulceration
scarring
strictures
Barrett esophagus
GERD: Barrett esophagus
development of abnormal metaplastic tissue- premalignant
3-fold increased risk of developing adenocarcinoma of the esophagus
over all survival only 17%
Hiatal Hernia: Definition
A defect in the diaphragm that allows part of the STOMACH to pass INTO the THORAX
Hiatal Hernia: Main Types (2)
- Sliding hernia
- Paraesophageal hernia
Type 1: Sliding Hernia
usually small and often does not need treatment
Type 2: Paraesophageal Hernia
part of the stomach pushes through the diaphragm and stays there
Hiatal Hernia: Pathophysiology
Exact cause is unknown
Age related
Injury or other damage may weaken the diaphragm muscle
Repeatedly putting too much pressure on the muscles around the stomach (severe coughing, vomiting, constipation and straining to have a BM)
Hiatal Hernia: Risk Factors (3)
age
obesity
smoking
Hiatal Hernia: CM (5*)
asymptomatic
belching
dysphagia
chest or epigastric pain
*common for GERD and Hiatal Hernia to coexist
Hiatal Hernia: Treatment
Mostly a conservative treatment:
Teaching: small,
frequent meals, avoid
lying down after eating
Avoid tight clothing and
abdominal supports
Weight control for
obese individuals
Antacids for the
GERD/esophagitis
symptoms
Surgery if the conservative treatments don’t work
Gastritis: Definition
inflammatory condition of the stomach
ACUTE Gastritis: Definition
Temporary inflammation of the stomach lining ONLY (intestines NOT affected)
Generally last from 2-10 days
ACUTE Gastritis: Etiology (3)
irritating substance (alcohol)
drugs (NSAIDs)
infectious agents
CHRONIC Gastritis
Progressive disorder with chronic inflammation in the stomach
Can last weeks to years
CHRONIC Gastritis: Complications (4)
PUD
bleeding ulcers
anemia
gastric cancers
CHRONIC Gastritis: Main Etiologies (2)
Autoimmune: attacks parietal cells
H. pylori infection
What is H. pylori?
Helicobacter pylori bacterium
Gram negative spiral bacteria that thrives in an ACIDIC environment
When it becomes overgrown, causes 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
OR
contaminated food or water
Acute OR Chronic Gastritis CM (10)
sometimes none
anorexia
N/V
stomach burn
upset stomach
postprandial discomfort (symptoms soon after you eat)
intestinal gas
hematemesis (blood in vomit)
tarry stools
anemia
Acute Gastroenteritis: Definition
inflammation of stomach AND small intestine
Usually lasts 1-3 days but may last as long as 10 days
Acute Gastroenteritis: Etiology (3)
Viral infections: Norovirus and rotavirus
Bacterial infections: E. coli, salmonella, and campylobacter
Parasitic infections
Acute Gastroenteritis: CM (4)
watery diarrhea (may be bloody if bacterial)
abdominal pain
N/V
Fever, malaise
Acute Gastroenteritis: Complication (1)
fluid volume deficits (worried about dehydration)
Peptic Ulcer Disease (PUD): Definition
Ulcerative disorder of the upper GI tract
ulcer in esophagus:
esophageal ulcer
ulcer in stomach:
gastric ulcer
ulcer in duodenum:
peptic ulcer
Develops when the GI tract is exposed to acid and H. pylori
Aggressive Factors for Developing Ulcers? (5)
H. pylori
NSAIDs
Too much acid secretion
Pepsin
Smoking
Defensive Factors to help GI Tract? (4)
Mucus
Bicarbonate
Increase blood Flow
Prostaglandins
PUD: Etiology (6)
H. pylori
injury causing substances (NSAIDs, ASA, alcohol)
excess secretion of acid
smoking
family history
stress (increased gastric acid secreted with the stress response)
Risk factors: NSAID-Induced PUD (6)
age
higher doses of NSAIDs
history of PUD
use of corticosteroids and anticoags
serious systemic disorders
H. pylori infection
PUD: Pathogenesis
Mucosa is damaged
Histamine is secreted resulting in:
increase in acid and
pepsin secretion- causes
further tissue damage
vasodilation- causes
edema
If blood vessels are destroyed, this results in BLEEDING
PUD: Classification
DUODENAL Ulcer: most common type, age- any; early adulthood
Gastric/peptic ulcer: age- peak 50-70;
why?
increased use of NSAIDs, corticosteroids, anticoags, and more likely to have serious systemic illnesses
PUD: CM (6)
sometimes none
N/V
anorexia
weight loss
bleeding
burning pain- in middle of abdomen that is usually when the stomach is empty
Gastric Ulcer: Pain characterisitcs, location, timing
burning, cramping, gas-like
epigastrium, back
*1-2 hours after eating
Duodenal Ulcer: Pain characterisitcs, location, timing
burning, cramping, gas-like
epigastrium, back
*2-4 hours after eating
PUD: Complications (3)
“HOP”
H- hemorrhage
O- obstruction
P- perforation and peritonitis
