GI Disorders, Peptic Ulcers, Crohn's, and Ulcerative Colitis PDF

**GI Disorders- GERD (Gastroesophageal Reflux Disease)** Pathophysiology: \- Stomach acid flows back into the esophagus due to a weak or relaxed lower esophageal sphincter (LES). This acid irritates the esophagus lining. Signs & Symptoms: \- Heartburn (burning in chest) \- Regurgitation (acid i...

**GI Disorders- GERD (Gastroesophageal Reflux Disease)** Pathophysiology: \- Stomach acid flows back into the esophagus due to a weak or relaxed lower esophageal sphincter (LES). This acid irritates the esophagus lining. Signs & Symptoms: \- Heartburn (burning in chest) \- Regurgitation (acid in mouth or throat) \- Difficulty swallowing \- Chronic cough or sore throat Complications: \- Esophagitis (inflammation of esophagus) \- Barrett's esophagus (pre-cancerous changes) \- Strictures (narrowing of esophagus) Diagnostic Tests: \- Endoscopy: Views esophageal lining. \- pH monitoring: Measures acid in esophagus. \- Barium swallow: X-rays after drinking contrast liquid. Treatment & Management: \- Lifestyle: Avoid triggers (spicy/fatty foods, caffeine), weight loss, no smoking. \- Medications: Antacids, H2 blockers (ranitidine), proton pump inhibitors (PPIs, like omeprazole). \- Surgery: Fundoplication if severe. Rationale: \- Reduce acid and irritation to prevent complications. **Peptic Ulcers** Pathophysiology: \- Open sores in the stomach or duodenum caused by H. pylori bacteria or NSAIDs weakening the protective lining. Signs & Symptoms: \- Burning stomach pain (relieved by food or antacids). \- Nausea, vomiting, bloating. \- Dark, tarry stools (bleeding ulcer). Complications: \- Bleeding ulcers. \- Perforation (hole in stomach wall). \- Gastric outlet obstruction (blocking food movement). Diagnostic Tests: \- Endoscopy: Identifies ulcers. \- H. pylori testing: Blood, breath, or stool tests. \- Barium swallow: Highlights ulcers on X-rays. Treatment & Management: \- Medications: PPIs, antibiotics for H. pylori, antacids. \- Lifestyle: Avoid NSAIDs, smoking, alcohol. \- Surgery: Rare, for complications. Rationale: \- Heal the ulcer and prevent recurrence. **Crohn\'s Disease** Pathophysiology: \- Chronic inflammation of any part of the digestive tract (commonly the ileum and colon), likely autoimmune. Signs & Symptoms: \- Diarrhea (sometimes bloody). \- Abdominal pain/cramping. \- Weight loss, fatigue. \- Mouth sores. Complications: \- Fistulas (abnormal connections between organs). \- Abscesses (infected pockets). \- Intestinal obstruction. Diagnostic Tests: \- Colonoscopy: Views inflammation and takes biopsies. \- Imaging: MRI, CT for fistulas or obstruction. \- Blood tests: Inflammatory markers (CRP, ESR). Treatment & Management: \- Medications: Anti-inflammatories (steroids), immunosuppressants, biologics. \- Diet: Nutritional support, avoid triggers. \- Surgery: For complications like obstruction. Rationale: \- Reduce inflammation, manage symptoms, prevent complications. **Ulcerative Colitis** Pathophysiology: \- Chronic inflammation and ulcers in the colon and rectum, likely autoimmune. Signs & Symptoms: \- Bloody diarrhea. \- Abdominal pain/cramps. \- Urgency to defecate. \- Fatigue, weight loss. Complications: \- Toxic megacolon (colon dilation). \- Increased risk of colon cancer. \- Severe bleeding. Diagnostic Tests: \- Colonoscopy: Identifies inflammation and ulcers. \- Blood tests: Anemia, inflammation markers. \- Stool tests: Rule out infection. Treatment & Management: \- Medications: Aminosalicylates, steroids, immunosuppressants, biologics. \- Diet: Low-fiber during flares. \- Surgery: Total colectomy if severe. Rationale: \- Control inflammation and maintain remission. **Liver Cirrhosis** Pathophysiology: \- Scar tissue replaces healthy liver tissue due to chronic liver damage (e.g., alcohol, hepatitis), impairing function. Signs & Symptoms: \- Fatigue, jaundice (yellowing skin/eyes). \- Ascites (fluid in abdomen). \- Spider angiomas (red spots on skin). \- Easy bruising/bleeding. Complications: \- Portal hypertension (increased pressure in portal vein). \- Esophageal varices (bleeding veins). \- Hepatic encephalopathy (confusion from toxins). Diagnostic Tests: \- Liver function tests: AST, ALT, bilirubin. \- Imaging: Ultrasound, CT for liver structure. \- Biopsy: Confirms cirrhosis. Treatment & Management: \- Lifestyle: No alcohol, manage weight, vaccinations. \- Medications: Diuretics (ascites), beta-blockers (portal hypertension). \- Procedures: Paracentesis (fluid removal), liver transplant if severe. Rationale: \- Slow progression, treat complications, and maintain liver function. **Endocrine Disorders Topics** **1. Cushing Syndrome** ----------------------- Pathophysiology:\ Cushing Syndrome happens when your body has too much cortisol, a stress hormone produced by the adrenal glands. This can occur due to prolonged steroid use or because the adrenal glands make too much cortisol. Etiology (Causes): - - - - Signs and Symptoms: - - - - - - - Complications: - - - - - Diagnostic Tests: - - - - Treatment and Management: - 1. 2. 3. 4. **2. Addison Disease** ---------------------- Pathophysiology:\ Addison Disease occurs when the adrenal glands don't produce enough cortisol and aldosterone. This affects your body's ability to respond to stress, maintain blood pressure, and balance electrolytes. Etiology (Causes): - - - - Signs and Symptoms: - - - - - - - Complications: - - - Diagnostic Tests: - - - - Treatment and Management: - 1. 2. 3. **3. Hyperthyroidism** ---------------------- Pathophysiology:\ This occurs when the thyroid gland produces too much thyroid hormone (T3 and T4), speeding up the body's metabolism. Etiology (Causes): - - - - Signs and Symptoms: - - - - - - - Complications: - - - Diagnostic Tests: - - - - Treatment and Management: - 1. 2. 3. 4. **4. Hypothyroidism** --------------------- Pathophysiology:\ This occurs when the thyroid gland doesn't produce enough thyroid hormones, slowing down your metabolism. Etiology (Causes): - - - - - Signs and Symptoms: - - - - - - - - Complications: - - - Diagnostic Tests: - - - Treatment and Management: - 1. 2. 3. **Female Reproductive Diseases** **Pelvic Inflammatory Disease (PID)** Pathophysiology \- PID is an infection of the upper genital tract, primarily caused by \*Chlamydia trachomatis\* and \*Neisseria gonorrhoeae\*. \- It affects the uterus, fallopian tubes, ovaries, and cervix, leading to pelvic pain and vaginal discharge. Signs and Symptoms \- Often asymptomatic; however, symptoms may include: \- Adnexal tenderness \- Pain during intercourse \- Uterine tenderness \- Fever with chills \- Unusual bleeding Complications \- Ectopic pregnancy \- Infertility due to scarring and abscess formation Diagnostic Tests \- Pelvic examination and swabs for bacterial infection \- Ultrasound and laparoscopy for visual confirmation Treatment and Management \- Abstinence from intercourse for three weeks \- Antibiotics (e.g., doxycycline) \- Pain management with analgesics \- Education on safe sex practices **Endometriosis** Pathophysiology \- Characterized by endometrial-like tissue growing outside the uterus, often due to retrograde menstruation or cellular metaplasia. \- Leads to inflammation and scar tissue formation. Signs and Symptoms \- Chronic pelvic pain \- Painful menstruation and intercourse \- Fatigue and infertility Etiology \- Retrograde menstruation, transformed peritoneal cells, hormonal changes during puberty. Complications \- Decreased quality of life due to pain and emotional distress. \- Potential injury to reproductive structures. Diagnostic Tests \- Collaborative diagnosis via lab tests for biomarkers, ultrasound, manual pelvic exams. Treatment Options \- Medications: NSAIDs, hormonal therapies (contraceptives), progestins. \- Surgical options: Laparoscopic surgery or hysterectomy as a last resort. **Polycystic Ovarian Syndrome (PCOS)** Pathophysiology \- PCOS involves excessive androgen production leading to irregular ovulation and cyst formation in the ovaries. Signs and Symptoms \- Irregular menstrual cycles \- Hirsutism (excess hair growth) \- Weight gain and acne Etiology \- Insulin resistance linked to obesity and genetic predisposition. Complications \- Increased risk of high blood pressure, diabetes, fertility issues. Diagnostic Tests \- Ultrasound for ovarian size and cyst presence. \- Blood tests for hormone levels. Treatment Strategies \- Lifestyle changes: diet and exercise. \- Hormonal treatments (birth control) for cycle regulation. \- Medications to improve insulin sensitivity. **The Male Reproductive System** **Benign Prostatic Hyperplasia (BPH)** Definition and Overview: \- BPH is a non-malignant enlargement of the prostate gland, commonly leading to lower urinary tract symptoms (LUTS) in men. \- The prostate is located just below the bladder and plays a role in semen production. Prevalence: \- The condition\'s prevalence increases with age: \- 50-60% in men aged 60s \- 80-90% in men over 70 years old. Growth Phases: \- The prostate undergoes two growth phases: 1\. Early puberty (doubling in size). 2\. From age 25 onwards, continuing throughout life. Characteristics of BPH: \- Bladder Outlet Obstruction: As the prostate enlarges, it compresses the urethra, obstructing urine flow. \- Lower Urinary Tract Symptoms: Include nocturia, poor urine stream, hesitancy, and prolonged micturition. Pathophysiology: \- Characterized by stromal and epithelial cell proliferation in the prostate transition zone. \- Results in urethral compression and bladder outlet obstruction. \- Static components involve direct compression from enlargement; dynamic components relate to smooth muscle tension. Signs and Symptoms: \- Common symptoms include: \- Nocturia \- Poor urine stream \- Hesitancy \- Urinary retention (less common) Complications: \- Potential complications include: \- Urinary retention \- Urinary tract infections \- Bladder stones \- Kidney damage due to retention. Diagnostic Tests for BPH \- Medical History: Assess symptoms and medication history. \- Physical Examination: Includes abdominal and rectal examinations to assess prostate size and tenderness. \- Urine Tests: Dipstick tests to rule out infections. \- Blood Tests: PSA levels to screen for prostate cancer. \- Imaging: Ultrasound and transrectal ultrasound (TRUS) for assessing prostate and urinary tract conditions. Differential Diagnosis Conditions that may mimic BPH symptoms include: \- Urinary tract infections \- Prostatitis \- Urethral stricture \- Bladder or kidney stones \- Neurological disorders affecting bladder control. Treatment Options for BPH 1\. Medications: \- Alpha Blockers: Relax smooth muscle in the bladder neck (e.g., Tamsulosin). \- 5-alpha Reductase Inhibitors: Reduce prostate size (e.g., Dutasteride). \- Combination therapy may be used if single agents are insufficient. 2\. Surgical Interventions: \- Recommended when medications fail or complications arise. \- Procedures include: \- Transurethral resection of the prostate (TURP) \- Transurethral incision of the prostate (TUIP) \- Other minimally invasive techniques such as microwave thermotherapy. **Erectile Dysfunction (ED)** Definition: \- ED is characterized by the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Causes: Common causes include: \- Alcohol use \- Depression \- Diabetes \- Vascular diseases \- Prostate injuries \- Hypertension \- Atherosclerosis Diagnosis: Includes: \- Medical and sexual history review. \- Physical examination focusing on nerve function and circulation. \- Laboratory tests assessing blood count, urinalysis, lipid profile, and testosterone levels. Treatment Options: 1\. Address underlying causes. 2\. Medications such as: \- Sildenafil (Viagra) \- Testosterone replacement therapy if indicated.