Gastrointestinal Disorders Overview

Gastrointestinal Disorders

• GERD (Gastroesophageal Reflux Disease): Weak lower esophageal sphincter allows acid and pepsin reflux into the esophagus.

• GERD Risk Factors: Obesity, family history, smoking, alcohol consumption, fatty diet, lying down after eating. Hiatal hernia is also a risk factor.

• Hiatal Hernia: Stomach or other organs push through the diaphragm into the chest. Pain often occurs 30-60 minutes after eating in the retrosternal area (behind the breastbone).

• PUD (Peptic Ulcer Disease): Ulcers in the upper GI tract caused by exposure to acid and pepsin secretions; often scarring occurs.

• PUD Causes: H. pylori bacteria, alcohol, smoking, medications (especially NSAIDs).

• PUD Symptoms Worsened By: Empty stomach; relieved by food.

• Bowel Obstruction: Blockage preventing chyme (food material) from moving through the gut.

• Bowel Obstruction Types:

• Mechanical: Caused by physical blockages like adhesions, torsion (twisting), hernias, intussusception (one part of the bowel slides into another part), or cancer.

• Non-mechanical: Caused by impaired peristalsis (muscle contractions that move food through the gut), often after surgery or narcotic use.

• Bowel Obstruction Clinical Manifestations (CM): Abdominal pain, distension, nausea/vomiting, constipation/diarrhea, hyperactive or hypoactive bowel sounds.

• Bowel Obstruction Red Flags: Abrupt onset of pain, guarding (tensing of abdominal muscles), tachycardia (rapid heart rate), fever, bloody stool.

• Diverticulosis: Formation of small pouches (diverticula) in the colon wall, often asymptomatic. May experience cramping, bloating, and constipation.

• Diverticulitis: Infection of diverticula, causing intense symptoms.

• Diverticulitis CM: Cramping abdominal pain (often in the lower left quadrant), diarrhea/constipation, nausea/vomiting, fever, elevated WBC (leukocytes), gas, and potentially bloody stool (diverticular hemorrhage).

• Ulcerative Colitis: Chronic inflammation with ulcers in the large intestine and rectum, characterized by continuous ulceration. Associated with diarrhea, bloody stool, cramping pain, and increased risk for colon cancer.

• Crohn's Disease: Chronic inflammation with ulcers that can affect any part of the GI tract, marked by skip lesions (inflammation in segments separated by healthy tissue). Ulcers affect the entire bowel wall and are associated with abdominal pain, diarrhea, and possible anemia (if there's bleeding).

• Lower GI Complications: Fistula (abnormal connection between organs), abscess (collection of pus), perforation (hole in the gut with leakage into the abdomen leading to peritonitis), and necrotic bowel (tissue death due to lack of blood flow).

• Fistula: Abnormal opening allowing GI contents to leak out into other organs or skin.

• Abscess: Collection of pus.

• Perforation with Peritonitis: Rupture in the GI tract, leaking contents into the abdomen causing severe pain.

• Necrotic Bowel: Lack of blood supply to the bowel leading to tissue death.

• Portal Hypertension (PHTN): High blood pressure in the portal vein (drains blood from the abdomen to the liver). Blood flow to the liver is obstructed.

• PHTN CM: Esophageal varices, ascites, splenomegaly.

• Esophageal Varices: Enlarged, swollen veins in the esophagus, potentially leading to rupture and bleeding (a serious and often life-threatening complication).

• Ascites: Increased fluid in the peritoneal cavity (lining of the abdomen). This fluid imbalance is associated with impaired albumin production.

• Splenomegaly: Enlarged spleen due to PHTN shunting blood into the splenic vein; leads to anemia and bleeding problems/infection risk.

• Cirrhosis: Liver tissue replaced by scar tissue. This leads to PHTN, biliary obstruction, and liver failure.

• Cirrhosis Causes: Alcohol (most common), viral hepatitis, autoimmune disorders, biliary cirrhosis, fatty liver disease, gallstones, drug overdose.

• Jaundice: Yellowing of skin and eyes due to elevated bilirubin levels; bilirubin is not excreted in the stool.

• Jaundice Causes: Increased red blood cell breakdown, impaired liver bilirubin processing, decreased excretion of bilirubin.

• Hepatitis Phases:

• Phase 1 (Prodromal/Preicteric): Fatigue, malaise, myalgia, anorexia, nausea, vomiting, diarrhea, abdominal pain, fever.

• Phase 2 (Icteric): Jaundice, itching (pruritis), liver tenderness, increased bilirubin levels.

• Phase 3 (Recovery): Jaundice resolution, return to normal.

• Hepatitis A: Transmitted orally; typically resolves in 4-8 weeks. Preventable by vaccination and good hygiene.

• Hepatitis B: Transmitted by blood and sexual contact, often chronic (lasting). Vaccine and safe practices available to prevent transmission. Highest cause of liver transplant.

• Liver Disease Lab Findings (often elevated): AST, ALT, ALP, bilirubin, prothrombin time, ammonia. Albumin is often decreased.

• Gallstones Composition: Cholesterol, bile pigments, calcium salts.

• Cholecystitis (Gallbladder Inflammation) Causes:

• Calculous (90%): Obstruction by gallstones.

• Acalculous: Inflammation without gallstones, possibly from disease or trauma.

• Pancreatitis: Pancreatic enzymes auto-digest pancreatic tissue. Common CM involve nausea and vomiting, as well as abdominal pain. NPO (nothing by mouth) is often indicated.

• Diabetes Mellitus: Blood glucose levels remain high due to problems with insulin secretion or use.

• Type 1 Diabetes: Body's immune system destroys insulin-producing cells. Cannot produce insulin.

• Type 2 Diabetes: Body's cells do not respond effectively to insulin. Some insulin is functional, but the response isn't effective enough. Risk factors can be modified.

• Diabetes Mellitus Labs: A1C (blood glucose control over time), blood glucose levels (fasting and random).

Test your knowledge on various gastrointestinal disorders including GERD, peptic ulcer disease, and bowel obstructions. This quiz covers risk factors, symptoms, and causes associated with these conditions. Perfect for students studying healthcare or related fields.