Gastrointestinal Disorders Quiz

Gastrointestinal Tract Disorders

• Disorders of Gastrointestinal Tract
• This is a course on disorders of the Gastrointestinal tract (GI Tract).
• The course is taught by Marina Gharibian, PhD, RN.

Terms to Remember

• Hematemesis: Blood in the vomit. Stomach blood is irritating. Vomiting may be bright red or coffee ground appearance
• Hematochezia: Bright red blood through the rectum.
• Melena: Black, tarry stool containing blood.
• Dysphagia: Difficulty swallowing.
• Odynophagia: Painful swallowing.

Signs and Symptoms Common to Most GI Disorders

• Anorexia: Loss of appetite.
• Nausea: Feeling of sickness.
• Vomiting: Throwing up.
• Dysphagia: Difficulty swallowing.
• Abdominal Pain: Pain in the abdomen.
• Diarrhea/Constipation: Changes to bowel regularity.
• Gastrointestinal Bleeding: Blood loss in the GI tract.

Gastroesophageal Reflux Disease (GERD)

• GERD: Acid and stomach content go back up into the esophagus.
• Normal: Lower esophageal sphincter (LES) is closed
• GERD: Lower esophageal sphincter (LES) is open

Definition and Pathophysiology of GERD

• Definition: Persistent reflux of gastric contents into the esophagus.
• Pathophysiology: A weak or incompetent lower esophageal sphincter (LES) allows reflux of gastric contents into the esophagus. The irritant effects of the refluxate causes injury.

GERD Symptoms and Prevention

• Heartburn: Pain in epigastric area that radiates to the throat, shoulder, or back, appearing 30–60 minutes after meals, and often an evening onset.
• Prevention: Avoid large meals, alcohol, smoking, and recumbent position several hours after a meal. Bend over for a short time. Sleep with head elevated and lose weight if overweight; remain upright after meals.
• Damaging factor: Acidic gastric fluids (pH <4.0) are very damaging.

Disorders of the Stomach

• Gastritis: Inflammation of the stomach lining.

Gastritis- Pathophysiology

• Gastritis: The stomach is protected by a mucosal barrier that prevents gastric secretions from damaging the stomach lining.
• Acute Gastritis: Transient inflammation of the gastric mucosa associated with irritants such as bacterial endotoxins, alcohol and aspirin.
• Chronic Gastritis: Characterized by chronic inflammatory changes that lead to atrophy of the stomach glandular epithelium.

Causes of Gastric Irritation and Ulcer Formation

• 1) Aspirin and Nonsteroidal anti-inflammatory drugs: Irritate the gastric mucosa, inhibit prostaglandin production (prostaglandins have healing effects) decreasing acid production and protective mucus secretion.
• 2) Infection with Helicobacter pylori (H. pylori): Thrives in acidic environment of the stomach disrupting the mucosal barrier, protecting against digestive enzymes.

Gastritis caused by H. Pylori

• Pathophysiology: The bacteria produce enzymes and toxins that interfere with the stomach's protective mechanisms, causing intense inflammation.
• End Result: Leads to gastric atrophy and peptic ulcers

Peptic Ulcer

• Description: Ulcerative disorders that occur in the upper GI tract, exposed to acid-pepsin secretions.
• Common symptoms: Spontaneous remissions and exacerbations which are common.
• Causes: Helicobacter pylori, aspirin, age, and smoking

Formation of an Ulcer

• Helicobacter pylori damages the protective mucus layer.
• Bacteria colonize the stomach mucosa.
• Acid passes through the weakened mucus layer, causing an ulcer.

Stomach Ulcer (Diagram Included)

• Diagrams of Stomach and Duodenal Ulcers show specific location.

Complications of Peptic Ulcer

• Hemorrhage: Bleeding from erosion into an artery or vein
• Perforation: Ulcer erodes through all layers of the stomach or duodenum wall.

Other Types of Ulcers: Stress Ulcers

• Curling Ulcers: GI ulcerations that develop in relation to stress such as large-surface-area burns, trauma, sepsis, acute respiratory distress syndrome, severe liver failure, major surgical procedures.
• Cushing Ulcers: Gastric, duodenal and esophageal ulcers resulting from intracranial injury or surgery.

Disorders of the Large Intestines

• Inflammatory Bowel Disease (IBD): Includes ulcerative colitis and Crohn's disease
• (Diagram Included) IBD: Diagrams of healthy, Crohn's, and Ulcerative colitis show appearances

Inflammatory Bowel Disease (IBD) Descriptions

• Crohn's Disease: Recurrent granulomatous inflammatory disease affecting any area of the gastrointestinal tract from the mouth to the anus.
• Description: Crohn's disease tends to affect the colon. Displays a cobblestone appearance owing to linear ulcerations.
• Ulcerative Colitis: A non-specific inflammatory condition confined to the rectum and colon. Displays prominent erythema and ulceration beginning in the ascending colon and most severe in the rectosigmoid area.

Granuloma- Meaning and Granuloma Macrophage

• Definition: A granuloma is an inflammation structure-formed collection of immune cells (WBCs) in response to chronic inflammation, perceived foreign substances and unable to eliminate.
• location: Found in lungs, head, skin etc
• Granuloma macrophage: Immune cell aggregates formed in response to chronic inflammatory stimuli.
• Macrophage morphologies: Contains a range of morphologies, including multinucleated giant cells

Pyogenic Granuloma

• Describes a specific subtype of granuloma

Crohn's Disease (Further Detail)

• Cobblestone Appearance: Mucosal surface of inflamed colon exhibits "cobblestone" appearance due to the presence of linear ulcerations and edema.

Cobblestone Appearance

• Definition: A specific appearance of the colon in relation to Crohn's disease, characterized by a bumpy or irregularly shaped surface. Demonstrates linear ulcerations and inflammation.
• Appearance: Diagrams and examples shown

Normal vs. Crohns Disease (Comparison)

• Normal: Diagrams of a healthy intestine showing normal appearance.
• Crohn's: Diagrams showing cobblestone appearance, fissures, and thickening of intestinal walls in Crohn's disease.

Ulcerative Colitis (Further Detail)

• Description: Ulcers begin in ascending colon, inflammation spreads throughout colon including the rectum and rectosigmoid

Crohn's vs. Ulcerative Colitis (Summary Comparison)

• Comparison: Tables comparing various characteristics like type of inflammation, level of involvement, areas of involvement, diarrhea, rectal bleeding, development of cancer, etc.

Colorectal Cancer

• Cause: Although the cause of colorectal cancer is unknown, it often originates from adenomatous polyps.
• Risk Factors: Incidence increases with age (over 50); family history and Inflammatory Bowel Disease (IBD).
• Polyps: Abnormal growths of tissue in colon. Diagram of polyps, removal of polyps and diagrams of stage 1, 2, 3 and 4 cancer

Layers of Bowel Wall

• Describes layers of colon wall with anatomical diagrams

Stages of Colon Cancer (Diagram Included)

• Stages: Diagrams of stages 1 through 4 of colon cancer progression.

Colon Cancer Prevention

• Focuses on dietary fat, sugar and fiber intake and the adequacy of vitamins and micronutrients as a part of dietary intake.
• Additional factors: high level of dietary fats in the body. Potential carcinogens are converted by the bacterial flora in the colon. Dietary fiber has a role in increasing stool bulk and dilution, and removal of potential carcinogens. Aspirin may have a protective role in preventing colorectal cancer.

Summary/Conclusion

Test your knowledge on gastrointestinal disorders such as GERD, gastritis, and peptic ulcers. This quiz covers symptoms, causes, and potential complications related to these conditions. Ideal for students studying medical or health-related subjects.