Gastrointestinal Tract Disorders

Gastrointestinal Tract

• The presentation aims to cover common diseases affecting different parts of the gastrointestinal tract (GIT).
• It also aims to introduce structural disruptions seen in common disorders and diseases.

Disorders of the Oesophagus

• Dysphagia: Difficulty swallowing, caused by problems with the oesophagus's musculature, obstructions (tumors), or neurological issues (like a stroke).
• Oesophageal tumors: Squamous cell carcinoma and adenocarcinomas are types of tumors that can occur in the oesophagus. These can be located higher or lower in the esophagus.
• Acid Reflux: A weak sphincter between the oesophagus and stomach allows acid reflux into the oesophagus. This causes irritation, heartburn, and potentially chronic oesophagitis (reflux oesophagitis).
• Barrett's oesophagus: A condition where abnormal columnar epithelium replaces the normal lining of the distal esophagus due to prolonged acid reflux. This is a premalignant condition.

Oesophageal Varices

• Portal hypertension: Overloading the portal venous system (due to cirrhosis) diverts blood to the oesophagus, leading to dilated submucosal veins in the lower oesophagus, resulting in esophageal varices.

Pathology of the Stomach

• Healthy stomach, erosion, ulcer, gastritis: Illustrations display the various structural elements of the stomach like lesser curvature, duodenum, body, greater curvature, and different stomach layers.
• Common stomach disorders: Gastritis (inflammation of the stomach lining), damage or erosion of the mucosa, ulceration (persistent erosion; ulcers can bleed, perforate, or heal through fibrosis). Some ulcers can progress to malignancy.

Gastritis

• Causes: Helicobacter pylori bacterial infection, excessive drinking, or smoking, prolonged NSAID use.
• Symptoms: Loss of appetite, nausea and vomiting, abdominal bloating, burning pain, and indigestion.

Causes and Treatments of Gastritis

• Triggers: Soda, coffee, sugar/energy drinks, processed foods, trans fats, sweets, and grains are among the foods that can aggravate gastritis.
• Relief: Turmeric, cranberry juice, peppermint, green tea, blueberries, ginger, avocado, beet juice, garlic, and yogurt can alleviate gastritis.

Peptic Ulcer

• Definition: A chronic, recurring disorder involving the formation of an ulcer in the stomach or duodenum. It is caused by a disorder in the nervous and hormonal regulation processes of the gastroduodenal system.

Gastric Ulcer vs. Duodenal Ulcer

• Gastric ulcer: Symptoms do not have a consistent pattern; eating may worsen or improve this condition.
• Duodenal ulcer: Pain is more consistent; pain can wake the patient up (at night); eating can relieve the pain but pain occurs within 2 to 3 hours after a meal.

Common Disorders of the Intestines

• Duodenal ulcers: Occur due to acid chyme damaging the duodenal mucosa.

Coeliac Disease

• Definition: A digestive disorder where eating gluten damages the small intestine. Symptoms result from damage to the mucosal villi of the small intestine, which leads to malabsorption.

Jaundice

• Cause: Pre-hepatic jaundice is due to excess haemoglobin breakdown; Post-hepatic/obstructive jaundice is due to bile duct obstructions and liver damage, which leads to bilirubin build-up in the blood.
• Symptom: Yellowing of the skin and eyes.

Gallstones

• Formation: Precipitation of bile acids and components (cholesterol) in the gallbladder forms gallstones.
• Symptoms: Often asymptomatic but may cause biliary colic (pain) or block bile outflow. Pancreatic tumors can also obstruct biliary outflow.

Pancreatitis

• Cause: Inflammation of the pancreas, causing considerable pain. Characterized by the release of amylase into the bloodstream.

Appendicitis

• Cause: Inflammation of the appendix. Pain manifests in the right lower quadrant of the abdomen, similar to a level T10 side pain.

Peritonitis

• Cause: Inflammation of the peritoneum. The ileum (part of the small intestine) can be affected due to compromises in motility or obstructions.

Inflammatory Bowel Disease (IBD)

• Crohn's Disease: A recurring inflammatory condition, affecting segments of the small and large intestines in patches; can impact lymphoid tissue areas (like the terminal ileum) affecting the full thickness of the intestinal wall.
• Ulcerative Colitis: An inflammatory condition typically affecting the lining of the large intestine (colon), starting from the rectum and progressing to other parts of the colon. It affects only the inner layer of the colon wall.

Meckel's Diverticulum

• Cause: A pouch in the lower part of the small intestine, possibly containing ectopic (out of place) gastric mucosa that creates irritation from excess stomach acid.

Diverticular Disease

Outpouching of the descending and sigmoid colon mucosa due to high pressure.

Hemorrhoids

• Cause: Swollen and inflamed vascular structures in the anal canal that aid in stool control. Can cause pain, itching, and blood in the stool.

Prolapse

• Cause: organs fall down or slip out of place (like the rectum).
• Colorectal Cancer: A common malignancy of the large intestine (colon/rectum) which contributes to significant mortality.

This quiz covers common diseases affecting the gastrointestinal tract, with a focus on disorders of the oesophagus, including dysphagia, tumors, acid reflux, and Barrett's oesophagus. Test your knowledge of these conditions and their implications for health.