Chapter 29: Disorders of Esophagus, Stomach, and Small Intestine

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Questions and Answers

What is the most common symptom of dysphagia?

Difficulty swallowing (correct)

Painful swallowing (odynophagia)

Nausea and vomiting

Gastroesophageal reflux

Which medication class can block the formation of protective mucus in the gastrointestinal tract?

NSAIDs (correct)

Antihistamines

Proton pump inhibitors

Antifungals

Which of the following is NOT a common diagnostic tool for gastrointestinal issues?

Magnetic resonance imaging (MRI) (correct)

Barium x-rays

Upper endoscopy

Videocapsule endoscopy

What is the primary cause of Barrett's esophagus?

Gastroesophageal reflux disease (GERD) Signup and view all the answers

Which of the following is a recommended treatment for upper gastrointestinal bleeding (UGIB)?

Hemodynamic stabilization Signup and view all the answers

What is the most common cause of dysphagia (difficulty swallowing)?

Neuromuscular dysfunction of cranial nerves IX, X, and XII Signup and view all the answers

Which part of the stomach is responsible for releasing HCl acid and pepsinogen?

Fundus Signup and view all the answers

Which hormone is released by G cells in the stomach?

Gastrin Signup and view all the answers

Which sphincter separates the esophagus from the stomach?

LES Signup and view all the answers

Which phase of stomach function involves signals from the small intestine to slow down stomach emptying?

Intestinal phase Signup and view all the answers

Which part of the small intestine is responsible for absorbing most nutrients?

Jejunum Signup and view all the answers

Which hormone is NOT released by the small intestine?

Gastrin Signup and view all the answers

What is the primary symptom of gastroesophageal reflux disease (GERD)?

Heartburn Signup and view all the answers

What diagnostic test is commonly used to evaluate GERD?

Endoscopy and manometry Signup and view all the answers

What is the purpose of the LINX® Reflux Management System in the treatment of GERD?

To use magnets to strengthen the esophageal sphincter Signup and view all the answers

What is the primary cause of a hiatal hernia?

Stomach pushes up through the diaphragm Signup and view all the answers

What is the primary symptom of pyloric stenosis?

Projectile vomiting Signup and view all the answers

What is the primary cause of acute gastritis?

Medications such as aspirin and NSAIDs Signup and view all the answers

What is the primary goal of treatment for peptic ulcer disease (PUD)?

Reduce acid levels and protect the gastric lining Signup and view all the answers

Which surgical procedure is used to decrease hydrochloric acid (HCl) production in PUD?

Gastroduodenostomy (Billroth I) Signup and view all the answers

What is the most common type of hernia?

Inguinal hernia Signup and view all the answers

Which of the following is a complication of an untreated hernia?

Incarceration of the intestine Signup and view all the answers

What is the primary method used to diagnose a hernia?

Patient history and physical examination Signup and view all the answers

Which surgical procedure is used to treat a hernia?

Herniorrhaphy Signup and view all the answers

What is the primary cause of Gastroenteritis according to the text?

Increased fluid shift into the lumen of the intestine Signup and view all the answers

Which of the following microorganisms is NOT mentioned as a cause of Gastroenteritis in the text?

Candida Signup and view all the answers

What is a common symptom of Celiac Disease mentioned in the text?

Steatorrhea (loss of fat in stools) Signup and view all the answers

How is Osmotic diarrhea characterized?

Decreased absorption leading to increased osmotic load in the lumen Signup and view all the answers

What type of reaction does Celiac Disease involve according to the text?

Autoimmune reaction triggered by gluten Signup and view all the answers

What is a common effect of Gastroenteritis on the body based on the provided information?

Electrolyte imbalance due to fluid loss Signup and view all the answers

Study Notes

Upper GI Tract

Consists of esophagus, stomach, and small intestine
Common disorders: Gastroesophageal reflux disease (GERD), Peptic ulcer disease (PUD), Gastroenteritis

Esophagus

Tube-like structure from mouth to stomach
Two sphincters: Upper esophageal sphincter (UES) and Lower esophageal sphincter (LES)

Stomach

Consists of fundus, body, and pylorus
Two sphincters: LES and pyloric
Phases: Cephalic (vagus nerve, acetylcholine), Gastric (HCl acid, pepsinogen, gastrin, intrinsic factor), Intestinal (small intestine sends signals to slow stomach emptying)

Small Intestine

Consists of duodenum, jejunum, and ileum
Lined with villi for absorption of nutrients
Releases hormones: Cholecystokinin, secretin
Ducts from liver and pancreas enter duodenum
Enterohepatic circulation: bile acids from ileum to liver

Gastroesophageal Reflux Disease (GERD)

Signs and symptoms: Dysphagia, Heartburn, Epigastric pain, Regurgitation, Dyspepsia
Diagnosis: Endoscopy and manometry
Treatment: Lifestyle changes, PPIs, antacids, Laparoscopic antireflux (fundoplication), Endoscopic radiofrequency delivery, LINX Reflux Management System

Hiatal Hernia

Stomach pushes up through opening in diaphragm
May be asymptomatic
Signs and symptoms: Dysphagia, Epigastric discomfort
Diagnosis: Endoscopy
Treatment: PPIs, histamine-2 blockers, surgery

Pyloric Stenosis

Constriction of pyloric sphincter
Can be congenital
Signs and symptoms: Gastroparesis, Projectile vomiting, Firm abdomen over pylorus
Surgical repair needed

Acute Gastritis

Inflammation of stomach lining
Causes: Medications (aspirin, NSAIDs, corticosteroids), Infection, Acute stress, Bile reflux, Alcohol abuse
Complaints: Heartburn, Epigastric pain
Diagnosis: Endoscopy
Treatment: Remove causative agents, PPIs, histamine-2 receptor antagonists

Chronic Gastritis

Caused by Helicobacter pylori
Treatment: Reduce acid levels and protect gastric lining, Antibiotic therapy, Lifestyle changes

Peptic Ulcer Disease (PUD)

Treatment: Reduce acid levels and protect gastric lining, Antibiotic therapy, Lifestyle changes
Therapeutic endoscopic treatment: Thermal coagulation therapy, Hemostatic clips, Fibrin sealant, Hemostatic nanopowder spray
Surgical treatment: Vagotomy, Gastric drainage

Hernia

Intestinal protrusion through abdominal wall
More common in males
Types: Inguinal (most common), Reducible, Incarceration, Strangulation
Symptoms and severity depend on location and extent
Diagnosis: Patient history and physical examination
Treatment: Herniorrhaphy (hernia repair)

Gastroenteritis

Irritation of lining of stomach, small or large intestine by pathogen or toxin
Infectious microorganisms: Norovirus, Rotavirus, Shigella, E. coli, Giardia
Transmitted person to person, water- or foodborne
Increased fluid shift into lumen of intestine, resulting in diarrhea
Damage of villi by pathogen or toxins

Celiac Disease

Hypersensitivity reaction to gluten
Gluten-derived protein (gliadin) causes symptoms
Unknown cause; autoimmune disease
Gluten ingestion results in bloating and gas
Steatorrhea (loss of fat in stools) may develop
Malnutrition is a concern

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Description

Test your knowledge on disorders of the esophagus, stomach, and small intestine. Explore common disorders such as GERD, PUD, and gastroenteritis, as well as basic concepts related to the esophagus anatomy, including sphincters.