Upper GI (Exam 3) Flashcards
Upper GI
Esophagus
Stomach
Beginning of small intestines
Lower GI
Small intestines
Colon
Recutm/anus
All upper GI disorder
GERD
Hiatal hernia
Gastritis
Acute gastroenteritis
PUD
Upper GI: Esophageal disorders
GERD
Hiatal Hernia
Upper GI problems: Inflammatory disorders of the stomach
Gastritis
Acute gastroenteritis
PUD
Dysphagia: Definitions
Difficult swallowing
Begins with solids and progresses to liquids
Dysphagia: Mechanical Obstructions
Stenosis or stricture
Diverticula
Tumors
Dysphagia: Neuromuscular
CVA storke
Achalasia - LES can’t open properly
GERD: What is it and why does it happen?
Gastroa Esophageal Reflux Disease
Heartburn
LES not closing properly which allows stomach contents to pass through
Why is GERD irritating?
HIGHLY acidic material passing through the LES into the esphogous
GERD: Etiology
Anything that alters closure strength of LES
or
Increase abdominal pressure
Things that can trigger GERD
Food and Drink Irritants
Cigarette
Sleep position
Obesity
Pregnancy
Pharmacologic agents
GERD: Clinical Manifestiations
-Heartburn (pyrosis)
-Dyspepsia (discomfort)
-Regurgitation
-Dysphagia
-Pulmonary symptoms
GERD: Complications
Tooth decay and bad breath
Chronic cough and asthma
Earache and hoarseness
GERD: Severe Complications
-Ulcerations in E
-Scarring in E
-Strictures in E
Most severe complication of GERD
Barrett esophagus (development of abnormal metaplastic tissue - premalignant)
Three fold increased risk of developing adenocarcinoma of the esophagus
17% survival rate
Hiatal Hernia
A defect in the diaphragm that allows part of the STOMACH to pass into the THORAX
Sliding hernia
usually small and often do not need treatment
peritoneum stays intact and restrains size of the hernia
Paraesophageal Hernia
Part of the stomach pushes through the diaphragm and stays there
Rolling hernia
Peritoneum becomes thinner and stomach enters into chest area
Hiatal hernia: What causes it?
Injuring or damage may weaken the diaphragm
Repeatedly putting too much pressure:
Coughing - Vomiting - Constipations straining
Hiatal Hernia: RF
Age
Obesity
Smoking
Hiatal Hernia: Clinical manifestations
-Asymptomatic
-Belching
-Dysphagia
-Chest pain
Hiatal Hernia: Treatment (non pharm)
Small and avoid lying down after eating
Avoid tight clothing
Weight control
Gastritis
Inflammatory condition of the stomach
Acute Gastritis
TEMPORARY inflammation of the STOMACH linings. (Intestines are NOT affected)
Acute gastritis: How long does it last
2-10 days
Acute gastritis: Etiology (Triggers)
-Irritating substances (alcohol)
-Drugs (NSAIDS)
-Infectious agents
Chronic Gastritis
Progressive disorder with chronic inflammation in the stomach
Chronic Gastritis: Complications
PUD
Bleeding
Ulcers
Anemia
Gastric cancers
Chronic Gastritis: Two main etiologies
- Autoimmune –> attacks parietal cells
- H. pylori infection
H. Pylori
Helicobacter pylori bacterium = Gram negative spiral
Acidic environment
H. Pylori can cause?
Chronic gastritis
PUD
Stomach Cancer
How is H. Pylori transmitted
Person to person via saliva fecal matter or vomit
Contaminated food and water
Acute or Chronic Gastritis: Clinical Manifestations
Vomiting
Burning
Postprandial discomfort (Symptoms right after eating)
Gas
Tarry stools
Acute Gastreoenteritis
Inflammation of stomach AND SMALL intestine
Acute Gastroenteritis: Etiology
-Viral infections: Norovirus and rotavirus
-Bacterial infections: E coli and salmonella
-Parasitic infections
How long does Acute Gastroenteritis last
1-3 days but may last as long as 10 days
Acute Gastroenteritis: clinical manifestations
Watery diarrhea: Bloody if bacterial
Abdominal pain
N/V
Fever, malasie
Acute Gastroenteritis: Complications
Fluid volume deficits
Peptic Ulcer Disease
Ulcerative disorder of the upper GI tracts
Ulcers in the stomach are called
gastric ulcers
Ulcers in the stomach are called
Gastric ulcers
Ulcers in the duodenum are called
Peptic ulcer in the first part of the small intestine
When does PUD most commonly happen?
Stomach is exposed to acid environment and h.pylori
PUD: Etiology (Triggers)
H. Pylori
NSAID
Alcohol
Smoking
ASA
Excess secretion of acid
Fx
PUD: Risk factors
-NSAID use
-H pylori infections
-Older age
-Use of corticosteroids
-Use anticoags
-Serious systemic disorders
PUD: Pathogenesis
Mucosa is damaged so the immune systems release histamine resulting in:
In acid and pepsin secretion – causes further tissue damage
Vasodilation – causing edema
This can cause bleeding of the blood vessels are damaged
PUD: Duodenal Ulcers
Most common type
Develops at any age more commonly early adulthood
PUD: Gastric Ulcers r/t
Age = Peak 50-70
r/t: Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses
PUD: Clinical Manifestations
Sometimes none if not bleedings
NV
Weight loss
Burning pain – in middle of abdomen that is usually worse when the stomach is empty
How to tell a difference between gastric and duodenal ulcers
Characteristics
Location
Timing
Characteristics: Burning cramping gas
Locations: Epigastrium and Back
Timing:
Gastric = 1-2 hrs after eating
Duodenal = 2-4 hrs after eating
PUD: Complications
HOP
Hemorrhage
Obstructions
Perforations and peritonitis
