Stomach Disorders PDF
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Summary
This document provides a detailed examination of various stomach disorders, including peptic ulcer disease and gastritis. It covers the etiologies, symptoms, pathogenesis, and treatment options for these conditions. The information is focused on the medical aspects of these pathologies.
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TOMACH S Problems usually either with secretion or motility Cardinal signs:pain, altered ingestion, altered digestion,gastrointestinal tract bleeding (GIT) Peptic Ulcer Disease Chronic erosion, destruction, and ulceration in the lining of the stomach and duodenum Etiology: Vario...
TOMACH S Problems usually either with secretion or motility Cardinal signs:pain, altered ingestion, altered digestion,gastrointestinal tract bleeding (GIT) Peptic Ulcer Disease Chronic erosion, destruction, and ulceration in the lining of the stomach and duodenum Etiology: Various causes, most common: H pylori infection and NSAID use Contributing factors: smoking, excessive alcohol use/ drug use, emotional stress, psychosocial components Manifestations: Asymptomatic Epigastric pain and dyspepsia Complications include bleeding, perforation, obstruction Treatment: Identify causative factor If H pylori - H pylori eradication w/ triple or quadruple therapy ○ Acid inhibiting therapy NSAID - H2 receptor antagonist and cease NSAID Gastritis Condition of gastric mucosal irritation or injury that results in histologically confirmed inflammation Acute Chronic Etiology: tiology: E Infection induced - usually due to H pylori Infection induced - usually due to H pylori Drug induced- NSAIDs, steroids, some chemotherapeutic Chemical and caustic agents-(NSAIDS, excessive alcohol drugs, alcohol, and iron supplements ingestion, radiation exposure) Pathogenesis: Occurs with critical illness, due to physiologic stress and ischemic changes caused by shock, hypotension, or release of Begins with superficial gastritis and advances to gastric vasoactive substances atrophy Pathogenesis: Gastric glandular structure are lost and or converted to Acute imbalance between mucosal injury and repair intestinal phenotype (metaplasia) mechanisms Gastric atrophy is precursor to gastric cancer Development of mucosal hyperemia and erosive changes Treatment: with histologic presence of inflammation Elimination of causative agent or exacerbating factors Treatment: Eradication of H pylori infection if indicated Elimination of causative agent or exacerbating factors Medications to enhance protection of gastric mucosa Eradication of H pylori infection if indicated Acupuncture Surgical interventions for GI bleeding Surgical intervention for GI bleeding Gastric Outlet Obstruction Epigastric pain and postprandial vomiting due to mechanical of structure in the pyloric region Etiology: Manifestations: Treatment: Includes gastric, duodenal, Abdominal pain, Bening - nasogastric tube suction, medications to suppress and or extraluminal pathology distention, gastric acid production, IV fluid and electrolyte replacement, bloating nutritional supplementation, trail liquid diet, endoscopic Malignancies of digestive balloon dilation or surgery organs Vomiting, weight loss, dehydration Malignant - based on underlying cause, may inclure stenting, Surgical and interventional chemotherapy, endoscopic balloon dilation, surgery induces obstruction May include early satiety and nausea Advanced palliative procedures Metastatic cancer Infantile Hypertrophic Pyloric Stenosis Hypertrophy of the pylorus muscles leading to eventual gastric outlet obstruction Etiology: Manifestations: Treatment: Frequently affects young Begins at 4-6 weeks of age Surgical infant intervention Gradual onset of worsening nonbilious projectile vomiting Unknown cause, linked Hunger / eagerness to feed after vomiting to genetic and Peristalsis may be visible in upper abdomen environmental factors Palpable mass may be present in right upper abdomen Lab findings include hypochloremia, hypokalemia, metabolic alkalosis Stomach Cancer Etiology: Risk factors include: H pylori infection, cigarette smoking, high alcohol ingestion, excessive dietary salt, inadequate fruit and vegetable consumption, pernicious anemia High nitrate diet may increase risk Manifestations: Known as alarm features Weight loss and abdominal pain Can include dysphagia, nausea, early satiety, occult GI bleeding, palpable abdominal mass Treatment: Depend on stage Upper endoscopy may be used for palliative procedures May require endoscopic resection, radiation, chemotherapy, and or surgical resection
