Gastrointestinal System

What is acute diarrhea?

Frequent passage of loose or watery stools (more than 3/day) lasting less than 14 days.

What are the two types of acute diarrhea?

-Large volume (due to excessive water/secretions) caused by virus or bacteria

-small volume (due to excessive motility).

What are common symptoms of acute diarrhea?

Fever, headache, vomiting, abdominal pain/discomfort, and malaise.

What defines constipation?

Changes in the frequency, size, consistency, and ease of stool passage, typically less than once every 3 days.

What are common causes of constipation?

Dehydration delayed gastric motility, sedentary lifestyle, low fiber diet, psychogenic factors, and drug side effects.

What is the initial treatment for constipation?

Lifestyle changes including increased fluid intake, fiber, exercise, and regular bowel habits.

What are the treatments for constipation if lifestyle changes don't work?

Laxatives, stool softeners, enemas, suppository

What is anorexia in the context of gastrointestinal disorders?

Loss of appetite or desire to eat despite physiological hunger stimuli.

What is nausea?

A subjective, unpleasant sensation that may precede vomiting, often caused by distention or irritation in the GI tract.

What is vomiting (emesis)?

Forceful emptying of stomach and intestinal contents through the mouth, mediated by the vomiting center in the brain.

What are the types of abdominal pain?

Parietal pain (localized and sharp), visceral pain (vague and dull), and referred pain (felt at a distance from the affected organ).

What is intestinal obstruction?

A mechanical or non-mechanical blockage affecting the patency of the bowel lumen, leading to symptoms like colicky pain and distention.

What are common signs and symptoms of intestinal obstruction?

Colicky pain, bowel distention, nausea, vomiting, anorexia, diarrhea, and reduced or absent bowel sounds and Peritonitis-this is a medical emergency.

What is ileus?

A partial or complete non-mechanical blockade of the intestine, often temporary and caused by factors like abdominal surgery or medications.

What are the symptoms of ileus?

Abdominal cramping, distention, nausea, vomiting, and failure to pass gas or stool and no bowel sound.

What are the treatments for ileus

-NPO

-NG tube to decompress

What is acute abdomen?

An episode of severe abdominal pain lasting several hours or longer, requiring medical attention.

What are the causes of acute abdomen?

-common gynecological causes

-medical causes

-appendicitis

What is peritonitis?

Inflammation of the peritoneum, often following perforation of the gut or organ,

What are symptoms of peritonitis?

pain, nausea/vomiting, and board-like rigidity.

What is Peptic Ulcer Disease (PUD)?

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum due to an imbalance between protective mechanisms and irritating factors.

What are common causes of Peptic Ulcer Disease?

Helicobacter pylori infection, excessive use of NSAIDs, and acid hypersecretion.

What are the clinical manifestations of PUD?

-(duodenal ulcers)-Dyspepsia, pain when the stomach is empty, Gain weight

-(gastric ulcers),pain after meals, weight loss (gastric)-hematemesis(blood in vommit)

What is the gold standard test for diagnosing PUD?

Endoscopy.

What is the primary non-invasive test for detecting H. pylori infection?

Stool specimen or urea breath test.

What are treatments for PUD

-Avoid food that cause excessive acid secretion

-Avoid alcohol and caffeine

-Stop or reduce NSAIDS

-Stop smoking

-MEDS-PPI, H2 blockers, antibiotics

What is gastroesophageal reflux disease (GERD)?

reflux of gastroduodenal contents into the esophagus

What are the causes of GERD

-Incompetent lower esophageal sphincter

-delayed esophageal peristalsis

-delayed gastric emptying

What is the function of the LES

Prevents reflux of acid into the esophagus

What causes the lower esophageal sphincter (LES) to relax, contributing to GERD?

Calcium channel blockers, narcotics, alcohol, nicotine, chocolate, and peppermint.

What are common signs and symptoms of GERD?

Heartburn, regurgitation, retrosternal pain, chest heaviness, chronic cough, and Barret esophagus--metaplasia

What is the gold standard diagnostic test for GERD?

Endoscopy.

-Barium radiograph to rule out diseases

What lifestyle changes can help manage Gastroesophageal Reflux Disease (GERD)?

Weight Loss, avoid alcohol, caffeine, peppermint, chocolate, smoking

What medications are commonly used to treat GERD?

proton pump inhibitors (PPIs), H2-blockers, and surgery

What is a hiatal hernia?

A condition where the stomach protrudes through the diaphragm, which can be asymptomatic or cause GERD symptoms.

What is diverticulosis?

Herniation or outpouching of the mucosa and submucosa layers, often asymptomatic, primarily found in the sigmoid colon.

What is diverticulitis?

Inflammation of diverticula in the bowel wall, which can lead to complications like perforation and abscess formation.

What are common symptoms of diverticulitis?

Acute LLQ abdominal pain, altered bowel habits, low-grade fever, nausea, vomiting, and guiac-positive stools.

What are labs/tests for divercutilitis

-CBC: slight leukocytosis

-SER: High

What is appendicitis?

Inflammation of the vermiform appendix, often due to obstruction.

What are the classic symptoms of appendicitis?

Acute periumbilical pain that localizes to the RLQ, anorexia, nausea, and vomiting.

What physical exam signs are associated with appendicitis?

Maximal tenderness at McBurney's point, Rovsing's sign, psoas sign, and obturator sign.

sign and symptom of appendicitis that indicates an emergency

perforation with sudden cessation of pain and subsequent peritonitis

What is Irritable Bowel Syndrome (IBS)?

A functional bowel disorder characterized by abdominal pain associated with defecation or changes in bowel habits.

What are common treatments for IBS?

Stress reduction, dietary changes: increased fiber, laxatives, and prebiotics/probiotics.

What is Ulcerative Colitis?

A chronic inflammatory disease of the colon with diffuse ulceration, primarily affecting the rectum and sigmoid colon.

What are the symptoms of Ulcerative Colitis?

Frequent diarrhea with blood and mucus, crampy abdominal pain, and urgency to defecate.

How is ulcerative colitis diagnosed?

colonoscopy

how ulcerative colitis is managed/treated?

-anti-inflammatory meds

-removing part of colon

-at risk for developing cancer

What is Crohn's Disease?

A chronic inflammatory disease affecting any part of the GI tract, characterized by patchy inflammation.

What are the common age groups affected by Crohn's Disease?

Young adults and teenagers.

What are some potential triggers for Crohn's Disease exacerbations?

Uknown but theory's say Infection, allergies, immune disorders, dietary factors, and psychosomatic influences.

What is the pathophysiology of Crohn's Disease?

-Inflammation begins in the intestinal submucosa and spreads with discontinuous involvement, often affecting both large and small intestines.

What is a typical lesion found in Crohn's disease?

Granuloma with a cobblestone appearance.

What are common clinical manifestations of Crohn's disease?

Diarrhea, fluid electrolyte imbalance abdominal pain, fever, malaise, malabsorption with weight loss.

What is a common complication of Crohn's disease?

Fistula and abscess formation.

What is the primary diagnostic method for Crohn's disease?

-CBC showing increased WBC and decreased RBC, Hgb, Hct

- imaging like barium enema, sigmoidoscopy, or CT scan.

What dietary recommendations are made for Crohn's disease management and Medications?

-Nutritional supplements and a low residue, high-protein, high-calorie diet.

-Anti-inflammatory drugs

-antibiotics

-vitamin, mineral and electrolyte

What is the primary cause of jaundice?

Excessive destruction of red blood cells, impaired uptake of bilirubin by liver cells, or obstruction of bile flow.

What is acute cholecystitis?

Inflammation of the gallbladder, often due to gallstones, causing sudden intense abdominal pain.

What are the classic symptoms of acute cholecystitis?

Sudden onset abdominal pain in the epigastrium or RUQ-->positive murphy's sign, nausea, vomiting, and local tenderness.

-jaundice

What is the gold standard imaging test for diagnosing gallbladder disease?

-Ultrasound.

-LFT:AST and ALT elevated

What is the treatment for cholecystitis?

-Cholecystectomy (surgical removal of the gallbladder).

-restrict fats

What are the functions of the liver?

-Carbohydrate, fat, and protein metabolism

-storage of minerals and vitamins

-filtration of blood

-production of bile salts.

-elimination of bilirubin

What are the clinical manifestations of viral hepatitis during the prodromal period?

Flu-like symptoms, malaise, fatigue, anorexia, nausea, vomiting, and elevated serum bilirubin.

What are the clinical manifestations of viral hepatitis during the icterus period?

-Jaundice

-RUQ tenderness

-Pruritus (itching of skin)

-Brown colored urine, clay colored stool

-spider angioma

What are the clinical manifestations of viral hepatitis during the recovery period?

-jaundice decreases

-color of urine and stool return to normal

-bilirubin and enzyme levels return to normal

What is the primary mode of transmission for Hepatitis A?

-Fecal-contaminated drinking water and food.

-Raw shellfish grown in contaminated water

What are the key features of Hepatitis B infection?

Virus transmitted through body fluids; can be acute or chronic; presents with hepatomegaly and RUQ tenderness.

What are key features of Hepatitis C?

-transmitted through the exchange of blood and body fluids

-50% caused by IVDU

-blood transfusion only 4% of all cases

-no vaccine for c

What is the incubation period for Hepatitis C?

About 6-7 weeks.

What are key features of Hepatitis D?

-Always comes with Hepatitis B

Tests for hepatitis

-Anti-HAV IgM(acute infection)

-Anti-HAV IgG(person cured)

-HBV Surface Antigen HBs-Ag(Acute infection)

-HB surface antibody HbsAb (person cured)

What is cirrhosis?

Replacement of liver tissue by fibrous tissue, leading to portal hypertension and liver failure.

What are the causes of cirrhosis

-ETOH

-Viral hepatitis

-Biliary disease

What are common clinical manifestations of cirrhosis?

Weight loss, ascites, hepatomegaly, splenomegaly, jaundice, abdominal pain, and portal hypertension, esophageal varices-->Gi bleeding

What laboratory tests are used to diagnose cirrhosis?

Liver function tests (ALT, AST, alkaline phosphatase, bilirubin), coagulation studies, CBC, CT abdomen and ammonia levels

treatment of cirrhosis

-lactulose(for ammonia)

-liver transplant

What is acute pancreatitis?

-inflammation of the pancreas and surrounding tissue

-pancreatic enzymes auto-digest pancreas

What are common causes of acute pancreatitis?

Alcohol abuse, biliary tract disease, hyperlipidemia, infections, surgery/trauma, and drugs.

What are the clinical manifestations of acute pancreatitis?

Abrupt deep epigastric pain, nausea, vomiting, tachycardia, and abdominal pain that may radiate to the back.

What is the significance of elevated serum amylase and lipase in pancreatitis?

They indicate pancreatic inflammation and are used for diagnosis.

What is the role of lactulose in liver disease?

It helps reduce ammonia levels in patients with hepatic encephalopathy.

What is the primary treatment for acute pancreatitis?

Maintain fluid status, pain control, NPO, and gradual reintroduction of diet as tolerated.