Studied by 4 people
Lets cook
What is included in the upper GI System?
mouth
esophagus
stomach
duodenum
What is included in the lower GI system?
Small intestine
Digest and absorb nutrients
Large intestine
Water and electrolyte absorption
stores waste to be eliminated
Common symptoms for GI disorders
nausea and vomiting
diarrhea
heartburn
GI bleeding
anorexia
fever
incontinence
Type 1 Hiatal Hernia
"Sliding Hernia” Most common
Stomach and esophagus slide into the chest through the hiatus in the diaphragm
Creates a bell shaped dilation
Type 2 hiatal hernia
Nonaxial hernia- paraoesophageal
More of the stomach enters the thorax via the hiatus
Both types often present with chest pain and heartburn in supine position 30-60 mins after eating.
Hiatal Hernia and PT
symptomatic control with antacids and elevating the bed
possible need for surgery
Avoid supine, valsalva maneuver and anything that increases abdominal pressure.
Gastroesophageal reflux disease (GERD)
Reflux of gastric contents into the esophagus
Prevalence increases with age.
Causes of GERD
Pretty general causes
can be caused by certain foods
caffeine in high quantities
obesity
high abdominal pressure
Intrinsic sphincter pressure
Clinical presentation of GERD
heartburn 30-60 mins after eating like hiatal hernia
Includes reflux and sour taste in mouth.
Laryngitis
Morning hoarseness
Painful burning radiating to the back, neck, or jaw.
Treatment for GERD
surgery is not common
tightening the Lower esophageal sphincter if choosing surgery
Strenuous exercise can make symptoms worse
Avoid supine laying just after eating
Gastritis
Inflammation of the gastric mucosa. Can be acute or chronic.
Chronic is the majority of cases.
Causes of Gastritis
often times people with gastritis have high doses of prescribes NSAIDS or aspirin
Bacillus Helicobacter Pylori bacteria
Stress
Clinical Presentation of Acute gastritis
Epigastric pain
small abdominal distension
Painless GI bleed - Results in black Tar-like stool
Low grade fever if there is an infection.
Clinical Gastritis
Often asymptomatic
Some pain after eating.
Peptic Ulcer Disease
Break in the mucosal lining of any point in the GI tract exposed to acid-peptic juices.
Sores in the lining of the stomach, intestines and esophagus
Chronic can have relapsing lesions
Etiology of PUD
90% of all ulcers are strongly associated with H. pylori infection
Exposure to gastric acid and NSAIDS
Stress
depression
poor coping skills
Clinical Presentation of PUD
Gnawing, burning pain from the umbilicus to the sternum
Pain is increased on an empty stomach
occurs often at night time when we are in a fasted state
can result in weight loss but needs further testing to rule out cancer.
Vomiting blood that is red or black.
Coffee ground vomitus
Treatment for PUD
Most common is proton pump inhibitors
Avoid NSDAIDS
avoid foods that aggravate symptoms
Exercise to lower stress
Usually heals within a few weeks.
Celiac disease
Malabsorption syndrome
70% in women
Destroys villi that line the small intestine
inability to absorb fat, protein, vitamins and minerals.
Triggered by gluten
Risk factors for celiac
other present diseases
lupus
diabetes
thyroid disease
Clinical presentations of celiac
skin rash
mouth sores
bad abdominal cramps, gas and bloating
tingling in legs and feet
Best way to diagnose celiac disease
Gluten free diet to see if symptoms subside
Inflammatory Bowel Disease
autoimmune disease
includes crohn’s and ulcerative colitis
Crohn’s disease vs Ulcerative colitis
Crohn’s can affect any portion of GI tract from mouth to anus
Most often involves the small intestine and colon
Ulcerative colitis is limited to the colon
Crohn’s risk factors
majority of cases are between 10 and 30 years old
disproportionately affects caucasian’s
Ulcerative Colitis risk factors
any age, but 10-40 years old is most common
Crohn’s prognosis
No cure
Increased risk of intestinal cancer
mostly able to manage the symptoms
Ulcerative Colitis prognosis
Chronic and can be debilitating
only cure is a colon resection
Inflammatory bowel disease and PT
Psoas abscess
Arthritis
Osteoporosis
Irritable bowel syndrome
Most common disorder of GI tract
anywhere in small and large intestines
Chronic condition with no inflammation
Abnormal contractions of intestines in response to stress, fatigue, alcohol, food
Clinical presentation of irritable bowel syndrome
At least three months of abdominal pain relieved by bowel movements along with 3 other symptoms.
bloating
stool changes
constipation
cramps
gas
Diverticular disease (diverticulitis)
uncomplicated
presence of outpouchings
herniation through colon muscular wall
Diverticulosis
complicated by inflammation
Secondary to low fiber diets
Etiology of diverticular disease
weakness of bowel muscles
inherited defect
obesity
Clinical manifestations of diverticular disease
80% are asymptomatic
anemia
severe pain in left quadrant of the abdomen that radiates to the back (diverticulitis)
pelvis pain
Prevention of diverticular disease
bran
Bulk laxatives'
exercise
parenteral fluids
Intestinal hernia
protrusion of organ or tissue die to weakness of abdominal muscle
equally affects men and women
5 million cases of some type of hernia in the U.S.
Clinical presentation of intestinal hernia
intermittent or persistent bulge
'can radiate from groin into testicles, thigh or flank
irritated by sudden movements
irritated by bowel movements
Treatment for intestinal hernia
taping is not recommended
can stitch the area in surgery
mesh repair to hold the intestine down
Appendicitis
most common acute surgical abdominal condition
affects 9% of people in the US and western countries
Peaks in 2nd and 3rd decade of life
more males
50% idiopathic
Clinical manifestations of appendicitis
Right lower abdominal quadrant pain is the most common
anorexia
vomiting
either really easy or or really hard to diagnose
Diagnosis of appendicitis
early to prevent perforation
family history
elevated wbc >20,000/mm3
Prognosis of appendicitis
Less than 1% mortality and morbidity
perforations come with complications like septic shock or peritonitis that have poor prognosis
