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Questions and Answers
What is the most common cause of Peptic Ulcer Disease (PUD)?
What is the most common cause of Peptic Ulcer Disease (PUD)?
Which type of peptic ulcer is most commonly found in the first few inches of the unprotected duodenum?
Which type of peptic ulcer is most commonly found in the first few inches of the unprotected duodenum?
What is the primary reason for the development of Peptic Ulcer Disease (PUD)?
What is the primary reason for the development of Peptic Ulcer Disease (PUD)?
What is a possible complication of Peptic Ulcer Disease (PUD)?
What is a possible complication of Peptic Ulcer Disease (PUD)?
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What is a common symptom of Peptic Ulcer Disease (PUD)?
What is a common symptom of Peptic Ulcer Disease (PUD)?
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What types of hiatal hernias are generally asymptomatic or have mild symptoms?
What types of hiatal hernias are generally asymptomatic or have mild symptoms?
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Which of the following is NOT a risk factor for developing GERD?
Which of the following is NOT a risk factor for developing GERD?
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What complication is MOST likely to occur with a paraesophageal hernia?
What complication is MOST likely to occur with a paraesophageal hernia?
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What is a common symptom of GERD?
What is a common symptom of GERD?
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What is the primary cause of GERD?
What is the primary cause of GERD?
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Which of the following drugs may interfere with the function of the LES?
Which of the following drugs may interfere with the function of the LES?
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What is Barrett's esophagus?
What is Barrett's esophagus?
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Which of the following is a possible treatment for hiatal hernia?
Which of the following is a possible treatment for hiatal hernia?
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What is the MOST appropriate treatment for a paraesophageal hernia that causes symptoms?
What is the MOST appropriate treatment for a paraesophageal hernia that causes symptoms?
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What is the MAIN difference between a sliding hernia and a paraesophageal hernia?
What is the MAIN difference between a sliding hernia and a paraesophageal hernia?
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What is the primary diagnostic test for gastric cancer?
What is the primary diagnostic test for gastric cancer?
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Which of the following symptoms is MOST commonly associated with gastric cancer?
Which of the following symptoms is MOST commonly associated with gastric cancer?
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Which of the following is a risk factor for celiac disease?
Which of the following is a risk factor for celiac disease?
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What is the pathophysiological mechanism underlying celiac disease?
What is the pathophysiological mechanism underlying celiac disease?
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What is the most common physical exam finding associated with metastatic gastric cancer?
What is the most common physical exam finding associated with metastatic gastric cancer?
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What is the protein found in wheat, barley, and oats that triggers celiac disease?
What is the protein found in wheat, barley, and oats that triggers celiac disease?
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What is the five-year survival rate for gastric cancer?
What is the five-year survival rate for gastric cancer?
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Which of the following conditions is NOT associated with celiac disease?
Which of the following conditions is NOT associated with celiac disease?
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What is the most common type of gastric cancer?
What is the most common type of gastric cancer?
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Which of the following is NOT a risk factor for gastric cancer?
Which of the following is NOT a risk factor for gastric cancer?
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In the context of Peptic Ulcer Disease (PUD), which of the following is a valid reason for endoscopy?
In the context of Peptic Ulcer Disease (PUD), which of the following is a valid reason for endoscopy?
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What is the primary function of medications used to treat PUD, apart from antibiotics?
What is the primary function of medications used to treat PUD, apart from antibiotics?
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Which of the following statements is TRUE regarding the incidence of gastric cancer?
Which of the following statements is TRUE regarding the incidence of gastric cancer?
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In the context of chronic gastritis, what is the primary function of the cells that are lost due to thinning of the stomach lining?
In the context of chronic gastritis, what is the primary function of the cells that are lost due to thinning of the stomach lining?
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What is the most common environmental cause of chronic gastritis?
What is the most common environmental cause of chronic gastritis?
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Which of the following is NOT a common symptom of acute gastritis?
Which of the following is NOT a common symptom of acute gastritis?
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What is the primary difference between acute and chronic gastritis regarding their duration?
What is the primary difference between acute and chronic gastritis regarding their duration?
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Besides H.pylori, what other factors are mentioned as potential causes of chronic gastritis?
Besides H.pylori, what other factors are mentioned as potential causes of chronic gastritis?
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Which of the following is a potential complication of untreated acute gastritis?
Which of the following is a potential complication of untreated acute gastritis?
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What is the typical treatment approach for chronic gastritis caused by H.pylori?
What is the typical treatment approach for chronic gastritis caused by H.pylori?
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When should massage be adjusted or avoided in patients with celiac disease?
When should massage be adjusted or avoided in patients with celiac disease?
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What is the most common early symptom of Crohn's disease?
What is the most common early symptom of Crohn's disease?
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Which of the following is a common extraintestinal manifestation of Crohn's disease?
Which of the following is a common extraintestinal manifestation of Crohn's disease?
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What is a potential complication of Crohn's disease that can lead to obstruction?
What is a potential complication of Crohn's disease that can lead to obstruction?
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What is the most common complication of ulcerative colitis?
What is the most common complication of ulcerative colitis?
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Which of the following is a characteristic feature of toxic megacolon?
Which of the following is a characteristic feature of toxic megacolon?
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What is the most common general symptom of malabsorption syndrome?
What is the most common general symptom of malabsorption syndrome?
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Which of the following is a characteristic symptom of fat malabsorption?
Which of the following is a characteristic symptom of fat malabsorption?
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What is a potential complication of calcium malabsorption?
What is a potential complication of calcium malabsorption?
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Which of the following is a possible symptom of iron malabsorption?
Which of the following is a possible symptom of iron malabsorption?
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Which of the following is a possible symptom of vitamin B12 malabsorption?
Which of the following is a possible symptom of vitamin B12 malabsorption?
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What is the recommended treatment for malabsorption syndrome?
What is the recommended treatment for malabsorption syndrome?
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What is the most common reason for malabsorption syndrome?
What is the most common reason for malabsorption syndrome?
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What is the most accurate way to diagnose malabsorption syndrome?
What is the most accurate way to diagnose malabsorption syndrome?
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What is the best way to confirm the diagnosis of Crohn's disease?
What is the best way to confirm the diagnosis of Crohn's disease?
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What is the primary objective of treatment for Crohn's disease?
What is the primary objective of treatment for Crohn's disease?
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Flashcards
Sliding Hernia (Type I)
Sliding Hernia (Type I)
Protrusion of the LES and gastroesophageal junction through the diaphragm, causing bell-shaped dilation.
Paraesophageal Hernia (Type II)
Paraesophageal Hernia (Type II)
Fixed protrusion of part of the stomach into the thorax, while LES stays below the diaphragm.
Hiatal Hernia Symptoms
Hiatal Hernia Symptoms
Most sliding hernias are asymptomatic; common symptoms include indigestion and chest pain.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD)
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GERD Signs and Symptoms
GERD Signs and Symptoms
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Complications of GERD
Complications of GERD
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Barrett's Esophagus
Barrett's Esophagus
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Diagnosis of Hiatal Hernia
Diagnosis of Hiatal Hernia
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Lifestyle Changes for Hiatal Hernia
Lifestyle Changes for Hiatal Hernia
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Treatment for Paraesophageal Hernia
Treatment for Paraesophageal Hernia
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Peptic Ulcer Disease (PUD)
Peptic Ulcer Disease (PUD)
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H.pylori
H.pylori
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Symptoms of PUD
Symptoms of PUD
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Types of ulcers
Types of ulcers
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Complications of PUD
Complications of PUD
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Acute Gastritis
Acute Gastritis
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Chronic Gastritis
Chronic Gastritis
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Signs of Acute Gastritis
Signs of Acute Gastritis
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Signs of Chronic Gastritis
Signs of Chronic Gastritis
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Etiology of Chronic Gastritis
Etiology of Chronic Gastritis
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Complications of Acute Gastritis
Complications of Acute Gastritis
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Treatment for Chronic Gastritis
Treatment for Chronic Gastritis
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Emotional Stress Effect
Emotional Stress Effect
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Gastric Cancer Risk Factors
Gastric Cancer Risk Factors
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Diagnosis of PUD
Diagnosis of PUD
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Treatment for PUD
Treatment for PUD
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Gastric Cancer Symptoms
Gastric Cancer Symptoms
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Common Symptom of Gastric Cancer
Common Symptom of Gastric Cancer
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Metastatic Finding in Gastric Cancer
Metastatic Finding in Gastric Cancer
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Gastric Cancer Diagnosis
Gastric Cancer Diagnosis
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Gastric Cancer Prognosis
Gastric Cancer Prognosis
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Celiac Disease Definition
Celiac Disease Definition
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Signs of Celiac Disease
Signs of Celiac Disease
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Celiac Disease Risk Factors
Celiac Disease Risk Factors
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Celiac Disease Symptoms
Celiac Disease Symptoms
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Celiac Disease Diagnosis
Celiac Disease Diagnosis
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Treatment for Celiac Disease
Treatment for Celiac Disease
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Crohn's Disease Definition
Crohn's Disease Definition
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Crohn's Disease Complications
Crohn's Disease Complications
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Ulcerative Colitis Symptoms
Ulcerative Colitis Symptoms
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Ulcerative Colitis Complications
Ulcerative Colitis Complications
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Diagnosis of Ulcerative Colitis
Diagnosis of Ulcerative Colitis
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Malabsorption Syndrome Definition
Malabsorption Syndrome Definition
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Symptoms of Malabsorption
Symptoms of Malabsorption
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Treatment for Malabsorption
Treatment for Malabsorption
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Crohn's Disease Pathophysiology
Crohn's Disease Pathophysiology
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Extraintestinal Symptoms of Crohn's
Extraintestinal Symptoms of Crohn's
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Prognosis for Celiac Disease
Prognosis for Celiac Disease
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Complications in Ulcerative Colitis
Complications in Ulcerative Colitis
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Study Notes
Diseases of the Gastrointestinal System Part 1
- Disorders covered include those of the esophagus, stomach, inflammatory bowel disease (Crohn's/UC), celiac disease, and malabsorption syndrome.
Disorders of the Esophagus
- Hiatal hernia is a protrusion of the stomach through the esophageal hiatus.
- Approximately 15% of the population has hiatal hernias, potentially rising to 60% in people over 60.
- Symptoms range from insignificant to severe reflux, indigestion, bloating, and difficulty swallowing.
- Etiology is often unknown, but risk factors include age-related diaphragm weakening, trauma, surgery, intense pressure on abdominal muscles, and obesity.
- Two types: Sliding hernia (Type I), which accounts for 95%, and paraesophageal hernia (Type II), which accounts for 5%.
- Sliding hernia involves the lower esophageal sphincter (LES) and gastroesophageal junction moving through the diaphragm; this creates a bell-shaped dilation.
- Paraesophageal hernia involves a separate portion of the stomach bulging alongside the esophagus, and the LES sits below the diaphragm.
- Common symptoms of hiatal hernias include indigestion, heartburn and occasional chest pain, with milder cases being asymptomatic.
- Complications include strangulation (painful, emergent complication) when the stomach is pinched and loses its blood supply.
- Diagnosis can be confirmed through a barium x-ray.
- Treatment for sliding hernias involves lifestyle changes such as raising the head of the bed, adjusting meal timing, controlling weight, and refraining from spicy/fatty foods and alcohol.
- Treatment of paraesophageal hernias may often involve surgical repair.
Gastroesophageal Reflux Disease (GERD)
- Backflow of stomach acid and enzymes into the esophagus causes inflammation (reflux esophagitis).
- The stomach lining has mucus-secreting cells protecting against acid.
- The esophagus does not have the same protective barrier, resulting in acid-induced inflammation and erosion.
- Malfunction of the lower esophageal sphincter (LES) allows the stomach contents to enter the esophagus.
- Common risk factors include hiatal hernia, obesity, pregnancy, fatty foods, chocolate, caffeinated/carbonated drinks, alcohol, smoking, and certain medications like anticholinergics, calcium channel blockers, and nitrates.
- Common symptoms include heartburn and regurgitation; pain can also spread to the neck, throat, and face.
- Other symptoms include sore throat, hoarseness, excessive salivation, sensation of a lump in the throat, and a dry cough.
- Possible complications include esophageal ulcers, chronic reflux, stricture, dysphagia, shortness of breath, and wheezing, and Barrett's esophagus (metaplastic changes due to acid irritation).
- Diagnosis is often based on symptoms, but testing including endoscopy, x-rays, LES pressure measurement, and esophageal pH testing is available if needed.
- Treatment often involves lifestyle changes, avoiding trigger foods, and medication like H2 blockers or PPIs.
- No contraindications for massage. However, massage timing considerations should be observed.
Disorders of the Stomach
- Stomach disorders include diaphragmatic hernia, pyloric stenosis, gastritis, peptic ulceration, and gastric cancer.
Diaphragmatic Hernia
- A protrusion of organs into the thoracic cavity through a weakened diaphragm opening (not the esophageal hiatus).
- Congenital diaphragmatic hernia involves an embryological diaphragm defect, often causing respiratory distress in newborn infants.
- Acquired diaphragmatic hernia is commonly from blunt force trauma, frequently associated with other thoracic and abdominal injuries.
- Symptoms include abdominal pain, decreased breath sounds, shortness of breath, audible bowel sounds in the chest, and occasionally, a visible bulge.
- Complications include incarceration of organs (leading to strangulation and possible perforation), potentially needing emergency surgical repair.
- Treatment depends on the cause and often involves emergency surgical repair for congenital hernias and delayed surgical repair or ongoing monitoring for acquired types.
- No contraindications for massage; focus on avoiding pressure over the affected area during massage.
Pyloric Stenosis
- Congenital or acquired narrowing of the pylorus (the muscle at the opening between the stomach and the small intestine), hindering food passage.
- Congenital pyloric stenosis appears in early infancy, often within the first month of life. Possible genetic component. Linked to conditions like Turner syndrome, trisomy 18, and esophageal atresia. Typically 3-4 times more common in males.
- Acquired pyloric hypertrophy is linked to gastritis or peptic ulcers near the stomach's antrum. –
- Symptoms include projectile vomiting after feeding, dehydration, and failure to thrive. Physical exam often shows an olive-sized mass in the epigastrium.
- Treatment is typically surgical (pyloromyotomy) and fluids to correct dehydration.
- No contraindications for massage. However, avoid massage if symptoms are present or in the affected region.
Acute Gastritis
- AKA Erosive Gastritis
- Characterized by temporary inflammation in the stomach lining due to issues like NSAIDs use, H. pylori infection, or alcohol consumption, smoking, and Crohn's disease.
- Common symptoms (if any) include epigastric pain, pressure, indigestion, nausea/vomiting, and in severe cases, overt hemorrhage, massive hematemesis, and melena.
- Symptoms typically resolve on their own.
- More severe cases could need medical attention to prevent complications like bleeding, perforation, and chronic gastritis.
- No contraindications for massage. However, avoid abdominal area until recovery if needed.
Chronic Gastritis
- Characterized by long-lasting inflammation of the stomach lining with infiltration of lymphocytes and plasma cells, often associated with the thinning of the lining (atrophy) and decreased production of acid and digestive enzymes.
- Common causes include autoimmune reactions, H. pylori infection, and certain medications like NSAIDS.
- Symptoms may be vague and mild, often asymptomatic. If symptoms occur, they can include vague/mild indigestion and dyspepsia, poor digestion if HCI secretion decreased. Possible malabsorption, leading to pernicious anemia and neuropathy.
- Treatment typically includes discontinuing causative agents, medications to reduce stomach acidity(e.g., PPIs), and following proper diet.
- No contraindications for massage. However, consider patient positioning that minimizes abdominal pressure.
Peptic Ulcer Disease (PUD)
- Ulcers or lesions in the stomach lining/duodenum.
- Categorized as duodenal or gastric ulcers, often linked to an imbalance between the body's defense mechanisms and harmful forces (HCl and pepsin), most commonly H. pylori.
- Other causes include NSAIDs, corticosteroids, and severe stress.
- Symptoms frequently include gnawing, burning, or aching epigastric pain, and often wax and wane in severity.
- Possible complications include perforation (from a leak in the stomach wall) and excessive internal bleeding.
- Treatment often involves identifying and addressing the cause, e.g., H. pylori antibiotics, discontinuation of NSAIDs, or medication to reduce stomach acid.
- Patients experiencing abdominal discomfort may need to avoid abdominal massage.
Gastric Cancer
- Cancer originating from the glandular cells of the stomach, typically adenocarcinomas.
- Significant risk factors include H. pylori infection, large/multiple gastric polyps, certain dietary factors (smoked, salted, pickled food, and nitrates), smoking, and obesity.
- Symptoms initially may be vague and mimic other stomach issues (e.g., initial satiety) but may later include unexplained weight loss, pain, nausea, vomiting, and issues with swallowing.
- Diagnosis often requires an upper endoscopy with biopsy.
- Prognosis is often poor, often a poor 5-year survival rate, with early metastasis being a factor.
- Treatment often requires surgery (partial stomach removal) with chemotherapy and radiation therapy being palliative.
- No contraindications for massage but be mindful of patient comfort and positioning.
Disorders of the Intestines: Celiac Disease
- An immune reaction triggered by gluten (a protein in wheat, barley, and oats).
- Individuals with celiac disease have a genetic predisposition.
- Pathophysiology involves immune response to gluten resulting in inflammation and flattening of the villi in the small intestine, leading to malabsorption.
- Individuals high-risk include those with a family history of celiac, type 1 diabetes, and other autoimmune disorders like autoimmune thyroiditis. Individuals with Down's Syndrome and Turner Syndrome are also at higher risk.
- Symptoms may include chronic diarrhea (foul smelling), bloating, malnutrition, weight loss, and malabsorption issues. Deficiencies linked include anemia, calcium deficiency (osteopenia), vitamin B12 deficiency, and protein issues. Dermatitis Herpetiformis is a secondary skin manifestation.
- Treatment involves a gluten-free diet, and corticosteroid use possibly prescribed.
- No contraindications for massage. However, consider the patient's comfort and symptoms during abdominal massage.
Inflammatory Bowel Disease (IBD)
- Crohn's disease and ulcerative colitis are broken down into separate categories, each with distinct characteristics.
Crohn's Disease
- Idiopathic, autoimmune condition affecting any portion of the gastrointestinal tract in an irregular (skip) pattern, including the mouth and perianal area.
- Associated with transmural inflammation (full thickness of bowel), leading to skip lesions, inflammation of the lining of the intestines (mucosa), and possibly abscesses and fistulas.
- Common to find involvement of the distal ileum and proximal colon in these diseases. Often linked to an increased risk in those with a family or genetic predisposition or those with conditions including autoimmune conditions.
- Symptoms include abdominal pain (often cramping), diarrhea (with potential bleeding), weight loss, and fatigue. Extraintestinal manifestations like enteropathic arthritis, erythema nodosum and uveitis can occur.
- Complications include potential flare-ups, obstruction through scarring, abscesses, fistulas, and increased risk of colon cancer.
- Diagnosis usually involves a combination of patient history, physical examination, stool and blood tests, and possibly an upper endoscopy or colonoscopy.
- Treatment initially focuses on relieving symptoms and reducing inflammation, potentially involving antidiarrheal medications, anti-inflammatories, corticosteroid treatment, dietary interventions, and possible surgery (removal of affected segments or repair of complications such as strictures).
Ulcerative Colitis
- A chronic, autoimmune condition confined to the large colon, commonly beginning in the rectum and sigmoid colon, progressing continuously along the colon.
- Associated with inflammation in the mucosal layer and potential complications such as bowel incontinence, bleeding, and pain.
- Common symptoms include recurring diarrhea (often bloody), bowel urgency, and often pain.
- Potential complications associated with the condition include toxic megacolon (massive colon swelling), severe/massive bleeding, and an increased risk of colon cancer.
- Diagnosis often requires a combination of patient history, physical examination, stool tests, and frequently, a colonoscopy.
- Treatment often involves a combination of antidiarrheal agents, anti-inflammatory medications, dietary changes, and possible surgery (colectomy).
Malabsorption Syndrome
- Absorption via the small and/or large intestine is impaired.
- Often a secondary complication of other diseases, most commonly related to damages to the mucous membrane within the gastrointestinal tract.
- Symptoms related include weight loss, various deficiencies (e.g., calcium, iron, vitamin), and potentially varied signs/symptoms, depending on the specific nutrient/vitamin deficiency resulting from malabsorption.
- Diagnosis requires a combination of patient history, physical examination, and possibly blood and stool tests to determine specific deficiencies and potential underlying issues.
- Treatment will depend on the cause, and aim to alleviate symptoms and restore proper nutritional balance.
- No contraindications for massage. However, consider patient's symptom presence and abdominal sensitivity when planning and executing massage.
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Description
This quiz tests your knowledge on Peptic Ulcer Disease (PUD) and hiatal hernias, covering their causes, symptoms, and treatments. Understand common complications and the differences between various types of hernias, while exploring risk factors for GERD. Assess your understanding of these gastrointestinal conditions.