GI Disorders .pdf

What Diseases or Disorders Can Affect the Esophagus? Two diseases that can affect the esophagus are hiatal hernia and gastroesophageal reflux disease. Hiatal hernia. A hiatal hernia occurs when a portion of the stomach gets pushed up through the opening of the diaphragm (called the esophageal hiat...

What Diseases or Disorders Can Affect the Esophagus? Two diseases that can affect the esophagus are hiatal hernia and gastroesophageal reflux disease. Hiatal hernia. A hiatal hernia occurs when a portion of the stomach gets pushed up through the opening of the diaphragm (called the esophageal hiatus). Gastroesophageal reflux disease. Gastroesophageal reflux disease, or GERD, is also referred to as “heartburn.” Gastroesophageal reflux disease occurs when the hydrochloric acid that is maintained in the stomach gets pushed into the esophagus. Causes of GERD include hiatal hernia, pregnancy, a malfunction of the esophageal sphincter, foods such as chocolate or fatty foods, and smoking. What are the signs and symptoms associated with gastroesophageal reflux disease? The signs and symptoms associated with gastroesophageal reflux disease include burning sensations in the epi- gastric region and/or throat, especially after meals and in the supine position. Nausea and vomiting with blood can also occur. What Is the Stomach, Where Is It Located, and What Is Its Function? The stomach is located in the right upper quadrant of the abdominopelvic cavity. The stomach mixes ingested food, saliva, and gastric juices (secretions) to form chyme, and also holds food until the small intestine is ready to accept this food. What Is Gastric Juice Made Up Of? Gastric juice consists of hydrochloric acid, intrinsic factor, gastric lipase, and pepsinogen Which Stomach Cells Secrete Gastric Juice? 1. Surface mucous cells and mucous neck cells secrete mucus, which acts as a protective barrier that prevents damage to the stomach. 2. Parietal cells secrete Hydrochloric acid, which kills most microorganisms and denatures proteins. Intrinsic factor, which is needed to absorb vitamin B12. (Vitamin B12 is needed to make red blood cells.) 3. Chief cells secrete: Gastric lipase, which breaks down fats. 1  Pepsinogen, which is converted to pepsin (the active form) when it makes contact with the hydrochloric acid. Pepsin breaks down protein. What Are Examples of Diseases and Disorders That Affect the Stomach? Some examples of stomach diseases are gastritis, stomach ulcers, and stomach cancer. What Is Gastritis? Gastritis occurs when the lining of the stomach becomes inflamed. Gastritis can be caused by bacterial or viral infections, medicines, alcohol, stress, and certain foods, such as foods that are hot and spicy. What are the signs and symptoms associated with gastritis? Gastritis presents with an upset stomach, nausea and vomiting, and heartburn. What Are Stomach Ulcers? Stomach ulcers are erosions of the stomach lining. If they are severe enough, these ulcerations can bleed. These ulcers can be caused by a bacterial infection, Helicobacter pylori. Increased amounts of stomach hydrochloric acid, cigarette smoking, drinking alcoholic beverages, and chronic aspirin use can contribute to stomach ulcers. What are the signs and symptoms associated with stomach ulcers? Stomach ulcers commonly present with severe abdominal pain and nausea associated with vomiting and loss of weight. The vomit can have a coffee grounds appearance, representing digested blood, or the blood can be red. What Is Stomach Cancer? The cause of stomach cancer is unknown, although stomach ulcers may be a factor. What are the signs and symptoms associated with stomach cancer? Stomach cancer commonly presents with a bloating sensation, gas, abdominal pain and cramping, bloody stool, nausea, and vomiting. What Is the Small Intestine? The small intestine is a muscular tube that extends from the stomach to the cecum of the large intestine. Most of the digested food is absorbed into the blood through the small intestine. The small intestine has three sections: 1. Duodenum 2. Jejunum 3. Ileum The cells that make up the endothelial lining of the small intestine contain microvilli that increase the surface area for the absorption of digested food. The small intestine contains glands that secrete an alkaline mucus that protects the lining from digestive enzymes and stomach acid, called Brunner’s glands, and glands that secrete digestive enzymes, called crypts of Licherkühn. 2 What Are Examples of Disorders That Affect the Small Intestine? A condition that affects the small intestines is Crohn’s disease. Crohn’s disease. Crohn’s disease, or CD, is also known as regional enteritis and is a chronic inflammatory disease that affects the mucosa layer, resulting in inflammation and ulceration. Intestinal stenosis can occur as a result of fibrosis in the submucosa layer and the hypertrophic muscular layer. Crohn’s disease typically affects both the small and large intestines, but it can occur anywhere in the gastrointestinal tract, from the mouth to the anus. This is regional enteritis because tissue changes can occur at any given section without adjacent regions being involved. The causes of Crohn’s disease are unknown, although there tends to be a familial pattern as well as an autoimmune component. Infectious agents, such as enteric bacteria, mycobacteria, viruses, and chlamydiae, have also been suspected. What are the signs and symptoms associated with Crohn’s disease? Crohn’s disease presents with abdominal pain and cramping, fever and diarrhea, decreased weight, and decrease in red blood cell production (caused by malabsorption). What Is the Function of the Large Intestine? The large intestine functions in the absorption of water, ions, and vitamins and the formation of feces. Water, inorganic salts, epithelial cells, undigested food (such as fiber), and bacteria are expelled from the body as feces. What Are Examples of Diseases or Disorders That Can Affect the Large Intestine, Rectum, and Anus? Examples of diseases or disorders that can affect the large intestine, rectum, and anus include appendicitis, colorectal cancer, diverticulosis, hemorrhoids, and ulcerative colitis. What Is Appendicitis? Appendicitis is inflammation of the appendix. Appendicitis can be caused by an obstruction of hard fecal matter in the lumen, resulting in bacterial growth. The fecal matter is called a fecalith and starts the inflammatory process. Inflammation can also be caused by the compression from a mass, such as a tumor, an abscess, or even a gallstone. Parasites can also cause blockages. An example of such a parasite would be pinworms. What are the signs and symptoms associated with appendicitis? The signs and symptoms of appendicitis initially present as mild epigastric or umbilical pain. As the appendix continues to swell, it pushes against the abdominal wall and parietal peritoneum, causing severe localized pain in the lower right quadrant. What Is Colorectal Cancer? Colorectal cancer is cancer that affects the mucosal lining of the rectum and colon. Most tumors that grow in the gastrointestinal tract tend to be carcinomas. These carcinomas can be found in the colon, stomach, esophagus, and small intestine. Cancer of the colon is the most common, and cancer of the small intestine is the least common. The cause of colon cancer is unknown, although high-fat, low-fiber diets may contribute, and polyps in the colon and/or rectum can become cancerous. 3 What are the signs and symptoms associated with colorectal cancer? Colorectal cancer presents with abdominal pain, especially at night; blood in the feces; “pencil thin” feces; bowel obstruction; weight loss; and anemia. What Is Diverticulosis? Diverticulosis is a condition of the colon (most common in the sigmoid colon) in which pouchlike sacs called diverticula protrude through the mucosa wall of the colon. When these sacs become inflamed or swell, the condition is called diverticulitis. The cause of diverticulosis is unknown, although infections of the diverticula and a poor diet lacking fiber have been known to cause the condition. Eating peanuts and seeds has been known to exacerbate the condition. What are the signs and symptoms associated with diverticulosis? Diverticulosis is often asymptomatic (having no symptoms). If the condition is becoming exacerbated, the individual may experience abdominal pain, constipation, diarrhea, blood in the feces, nausea, and fever. What Are Hemorrhoids? Varices in the veins of the rectum and anus are referred to as hemorrhoids. Hemorrhoids can be caused by an increased or elevated pressure in veins, pregnancy and labor, obesity, and chronic constipation that causes the individual to strain while moving his or her bowels. What are the signs and symptoms associated with hemorrhoids? Hemorrhoids present as bulges in the anal region. Bright red blood can be found in the feces, and there is pain during defecation and itching in the anal region. What Is Ulcerative Colitis? Ulcerative colitis, also known as UC, can be chronic or acute and is also an inflammatory and ulcerative process. This disease process is restricted to the large intestine, beginning at the rectosigmoid region and extending upward, until it eventually affects the entire colon. The cause of ulcerative colitis is unknown. What are the signs and symptoms associated with ulcerative colitis? The signs and symptoms of ulcerative colitis include watery diarrhea that contains blood and mucus. This diarrhea can be sudden and urgent. The individual can also present with a high fever, weight loss, anemia (decrease in red blood cells), malaise, and toxemia. There is also a risk of hemorrhage, which is a common complication of ulcerative colitis. Accessory Structures of the Gastrointestinal Tract. What Are the Accessory Structures of the Gastrointestinal Tract? The accessory structures of the gastrointestinal tract include the liver, gallbladder, and pancreas. 4 What Is the Function of the Liver? The liver functions in the metabolism of carbohydrates, lipids, and proteins; processes hormones and drugs; stores vitamins; and excretes bilirubin. What Is a Disease That Can Affect the Liver? A disease that can affect the liver is hepatitis. Hepatitis is the inflammation of the liver. Hepatitis can be caused by a bacterial infection; a viral infection, such as hepatitis B virus (HBV); a parasitic infection; alcohol abuse and drug abuse, including overuse of acetaminophen; and undercooked or contaminated food. What are the signs and symptoms associated with hepatitis? Hepatitis commonly presents with an enlarged liver, jaundice (yellow color to the skin and sclera of the eyes), abdominal pain, nausea and vomiting, weakness, and urine that is very dark. What Is the Gallbladder and Where Is It Located? The gallbladder lies between the lobes of the liver in the right upper quadrant. What Is the Function of the Gallbladder? The gallbladder stores bile. Under the influence of the hormone cholecystokinin, the gallbladder contracts, ejecting bile through the cystic duct into the common bile duct and into the duodenum of the small intestine, where it emulsifies fats. What Is a Disease of the Gallbladder? A common disease of the gallbladder is cholecystitis, which is the inflammation of the gallbladder as a result of the blockage of a cystic duct by a gallstone. What are the signs and symptoms associated with cholecystitis? Cholecystitis commonly presents as recurring colicky pain in the right upper quadrant that refers pain to the inferior angle of the right scapula. What Are Gallstones? Gallstones are made up of solidified bile salts, phospholipids, and cholesterol. What Is the Pancreas? The pancreas is located posterior to the stomach and is both an endocrine gland and an exocrine gland. About 99 percent of pancreatic cells are acini cells and function in exocrine secretion of pancreatic digestion. The other 1 percent are endocrine cells and are called the islets of Langerhans. What Do the Acini Cells Secrete? The acini cells secrete: Pancreatic lipase. Pancreatic lipase breaks down fats (triglycerides). Pancreatic amylase. Pancreatic amylase breaks down starches (polysaccharides). Pancreatic nucleases. Pancreatic nucleases include ribonuclease and deoxyribonuclease, which break down nucleic acids. Trypsinogen. Trypsinogen is converted to its active form trypsin (in the intestines by enterokinase), which breaks down protein 5 What Are Diseases That Can Affect the Pancreas? Two disorders of the pancreas are pancreatitis and pancreatic cancer. What Is Pancreatitis? Pancreatitis is inflammation of the pancreas. There are two forms: 1. Acute pancreatitis. This form of pancreatitis resolves and is commonly the result of a biliary obstruction, usually calculi (stone). 2. Chronic pancreatitis. This form of pancreatitis involves tissue changes that are not reversible and that result in progressive loss of both endocrine and exocrine function. The most common cause of chronic pancreatitis is chronic alcohol consumption. Pancreatitis presents as severe abdominal pain that is referred to the midthoracic region of the back and is described as a steady, deep, boring pain accompanied by nausea and vomiting. What Is Pancreatic Cancer? Pancreatic cancers that are exocrine tumors are called ductal adenocarcinomas. The majority of these tumors occur in the head of the pancreas and cause obstructions that result in jaundice. Pancreatic cancer is twice as com- mon in men at an average age of 55 years. The cause of pancreatic cancer is unknown, although alcohol consumption and smoking are risk factors. Pancreatic cancer commonly presents with severe abdominal pain that radiates to the thoracic region of the vertebral column, accompanied by weight loss, jaundice, nausea, vomiting, and fatigue 6