GIT DISEASE

Esophagitis

• Esophagitis is a condition where the esophagus is inflamed or irritated.
• Causes of esophagitis include:
  • Irritation from alcohol, hot fluids, spicy food, and heavy smoking.
  • Corrosive acids or alkalis, medication, large pills, and swallowing toxic substances.
  • Infections, such as bacterial, viral, and fungal infections.
  • Radiation therapy and cytotoxic chemotherapy.
  • Graft-versus-host disease (GVHD) and hiatal hernias.
• Common types of esophagitis include:
  • Reflux esophagitis (GERD), which occurs when stomach acid flows back into the esophagus.
  • Eosinophilic esophagitis, which is an allergic reaction that causes inflammation in the esophagus.

Symptoms of Esophagitis

• Symptoms of esophagitis include:
  • Difficult or painful swallowing (dysphagia).
  • Heartburn and a burning sensation in the esophagus.
  • Feeling of something stuck in the throat.
  • Mouth sores, bad breath, and blood in vomit (in severe cases).

Reflux Esophagitis (GERD)

• Reflux esophagitis occurs when gastric contents are passively regurgitated into the esophagus.
• It is related to hiatal hernia and lower esophageal sphincter.
• Common symptoms include:
  • Heartburn, especially after eating.
  • Regurgitation of food.
  • Difficulty swallowing.
• If left untreated, reflux esophagitis can lead to inflammation, erosion, and ulceration of the esophageal mucosa.

Eosinophilic Esophagitis

• Eosinophilic esophagitis is a chronic immunologically mediated disorder.
• It is caused by the release of histamine from sensitized mast cells in the esophageal wall.
• Symptoms include:
  • Dysphagia.
  • Eosinophilic infiltration of the esophageal mucosa.
  • Corrugated (wrinkled) esophagus.
  • Concentric mucosal rings.

Cancer of the Esophagus

• Esophagus cancer begins in the cells of the inner layer of the esophagus.
• It can invade the surrounding tissue and spread to other parts of the body.
• Types of esophagus cancer include:
  • Squamous cell carcinoma (SCC), which occurs in the upper part of the esophagus.
  • Adenocarcinoma, which occurs in the lower part of the esophagus.
• Risk factors include:
  • Smoking and alcohol consumption.
  • Low fiber diet, obesity, and acid reflux.
  • Male gender and age over 65.

Symptoms of Esophagus Cancer

• Symptoms of esophagus cancer include:
  • Dysphagia.
  • Pain when swallowing.
  • Pain in the chest or back.
  • Weight loss.
  • Heartburn.

Pathogenesis of Esophagus Cancer

• SCC is the most common type of esophageal cancer worldwide.
• Risk factors include tobacco and alcohol consumption.
• The pathogenesis of SCC involves:
  • Tobacco and alcohol-induced damage to cellular DNA.
  • Inflammation of the squamous epithelium.
  • Dysplasia and in situ malignant change.

Pathogenesis of Adenocarcinoma

• Adenocarcinoma of the esophagus occurs in the distal esophagus.
• It is linked to gastroesophageal reflux disease (GERD).
• Untreated GERD can progress to Barrett's esophagus (BE).
• The pathogenesis of adenocarcinoma involves:
  • Chronic reflux of gastric acid and bile.
  • Damage to the esophageal mucosa.
  • Metaplasia and dysplasia.

Pathological Changes

• Pathological changes in esophagus cancer include:
  • Dysplasia.
  • Metaplasia.
  • Adenocarcinoma.

Stages of Esophagus Cancer

• Stages of esophagus cancer include:
  • Stage 0: Abnormal cells only in the inner layer of the esophagus.
  • Stage I: Cancer cells have grown through the superficial lining of the colon/rectum wall.
  • Stage II: Cancer cells have grown into or through the wall of the colon/rectum.
  • Stage III: Cancer cells have invaded nearby lymph nodes.
  • Stage IV: Cancer cells have spread to other parts of the body.

Inflammatory Bowel Disease

• Crohn's disease and ulcerative colitis are types of inflammatory bowel disease.
• Causes of inflammatory bowel disease include:
  • Unknown causes.
  • Inheritable factors.
  • Microbial infections.
  • Dietary factors.
  • Oral contraceptive pills and NSAIDS.

Crohn's Disease

• Crohn's disease is a chronic, transmural inflammatory process of the bowel.
• It can affect any part of the gastrointestinal tract (GIT).
• Symptoms include:
  • Low-grade fever.
  • Prolonged diarrhea with abdominal pain.
  • Weight loss.
  • Fatigue.
  • Crampy or steady pain of the right lower quadrant.
• Lab diagnosis involves:
  • Barium enema for colon and CT colography.
  • Colonoscopy or sigmoidoscopy.
  • Cobblestone changes in terminal ileum.

Ulcerative Colitis

• Ulcerative colitis is a chronic inflammation of the large intestine.
• It is one of the diseases called inflammatory bowel disease.
• Ulcers form after inflammation has killed cells lining the rectum and colon.
• Symptoms include:
  • Rectal bleeding.
  • Loss of body fluids and nutrients.
  • Fatigue.
  • Weight loss.
  • Skin lesions.
• Lab diagnosis involves:
  • Stool specimen analysis to exclude infections and parasites.
  • Blood tests to show anemia, elevated WBC.
  • Sigmoidoscopy and colonoscopy to visualize the colon.
  • Barium enema x-ray.

Colon Cancer

• Colon cancer is a common type of cancer that affects the colon and rectum.
• It is caused by uncontrolled cell growth in the colon or rectum.
• Symptoms include:
  • Rectal bleeding.
  • Loss of appetite.
  • Unintended weight loss.
  • Nausea and vomiting.
  • Abdominal pain.
• Lab diagnosis involves:
  • Colonoscopy to view the entire colon and rectum for abnormalities.
  • Biopsy to analyze cancer markers.
  • CT scan to create a detailed picture of the cancer inside the colon and rectum.
  • Blood tests to show complete blood count and organ-function tests.

Stages of Colon Cancer

• Stages of colon cancer include:
  • Stage 0: Abnormal cells only in the inner lining of the colon/rectum wall.
  • Stage I: Cancer cells have grown through the superficial lining of the colon/rectum wall.
  • Stage II: Cancer cells have grown into or through the wall of the colon/rectum.
  • Stage III: Cancer cells have invaded nearby lymph nodes.
  • Stage IV: Cancer cells have spread to other parts of the body.