Gastrointestinal Disorders 2 - PDF

Gastrointestinal Disorders 2 Disorders of the Lower GI Tract Julie Severet GI Disorders  Esophagus  Gastroesophageal Reflux Disease (GERD)  Hiatal Hernia  Stomach/Duodenum  Peptic Ulcer Disease (PUD)  Intestines  Inflammatory Bowel Disease ...

Gastrointestinal Disorders 2 Disorders of the Lower GI Tract Julie Severet GI Disorders  Esophagus  Gastroesophageal Reflux Disease (GERD)  Hiatal Hernia  Stomach/Duodenum  Peptic Ulcer Disease (PUD)  Intestines  Inflammatory Bowel Disease  Diverticular Disease  Appendicitis Inflammatory Bowel Disease  Definition  chronic inflammation of intestinal tract  Etiology  autoimmune  environmental factors  genetic predisposition  Types  ulcerative colitis  crohn’s disease Ulcerative Colitis  Definition  ulceration of colon and rectum, distal, continuous  Pathophysiology  inflammation, edema --> abscess develop --> ulcerations --> destroy epithelium --> dec surface area, inc loss of fluid. Repeated attacks --> scar tissue Ulcerative Colitis  Clinical Manifestations  diarrhea weight loss  abdominal pain inc HR  fever anemia  dehydration  Complications  hemorrhage  toxicmegacolon  colon cancer Crohn’s Disease  Definition  any part of GI tract, skip lesions - separated segments  Pathophysiology  affected areas are edematous, swollen with ulcerations  all layers, deep --> cobblestone Crohn’s Disease  Clinical Manifestations  diarrhea  fatigue  abdominal pain  weight loss  Complications  strictures, obstructions  fistulas Inflammatory Bowel Disease  Diagnostic Tests  stoolstudies  barium enema  sigmoidoscopy/colonoscopy  Treatment  meds: sulfasalazine, steroids, ABX  surgery Diverticular Disease  Definition  diverticula - saclike outpouchings of mucosal layer of colon through muscle layer.  diverticulosis - asymptomatic diverticular disease  diverticulitis - inflammation of diverticula  Etiology  low fiber diet  dec in physical activity  effects of aging Diverticular Disease  Pathophysiology  diverticuli form at weak points in wall  smooth muscle thickens --> dec diameter, inc pressure --> more diverticuli  dec bulk in stool and dec diameter --> rupture diverticula or trapped stool causes diverticulitis  Clinical Manifestations  fever, chills  inc WBC  LLQ pain Diverticular Disease  Diagnostic Tests  sigmoidoscopy  barium enema  Treatment  uncomplicated disease: diet, fluid  acute: NPO, fluids, ABX Appendicitis  Definition  inflammation of appendix  Etiology  obstruction of lumen with fecalith  Pathophysiology  lumen obstructed --> no drainage of appendix  mucosal secretions continue --> inc pressure --> dec in blood flow --> mucosa ulcerates --> more inflammation --> gangrene, perforation Appendicitis  Clinical Manifestations  abdominal pain  rebound tenderness  fever  N/V  Complications  perforation  peritonitis  sepsis Appendicitis  Diagnostic Tests  WBC  abd x-ray, CT scan  Treatment  early: ABX, fluids  appendectomy Cholelithiasis  Definition  gallstones in gallbladder  Risk Factors  obesity  sedentary lifestyle  family history Cholelithiasis  Pathophysiology  bilesupersaturated with cholesterol --> cholesterol precipitates out, forms stones.  stones stay in gallbladder or migrate to ducts  Clinical Manifestations  stationary - heartburn, flatulence, epigastric discomfort, intolerance to fat  in duct - pain, jaundice Cholecystitis  Definition  inflammation of gallbladder, caused by stones, bacterial infection  Pathophysiology  gallbladder edematous, inflamed  pressure against distended wall of gallbladder -> dec in blood flow -> ischemia, necrosis -> scaring -> dec functioning Cholecytitis  Clinical Manifestations  pain  heartburn  nausea  flatulence  fever  jaundice Cholelithiasis/Cholecystitis  Diagnostic Tests  ultrasound  oral cholecystogram  intravenous cholangiogram  Treatment  meds to dissolve stones  pain meds  ABX  cholecystectomy