McCance Chapter 42 Alterations of Digestive System

Achalasia

Failure of a sphincter, usually the esophageal sphincter, to relax completely. Reducing the ability to move food down the esophagus.

Alkaline reflux gastritis

Inflammation from reflux of bile and pancreatic secretions

Anorexia nervosa (AN)

A disorder with both psychologic and physiologic components that begins with dieting to lose weight and manifests into an inappropriate self-control behavior; continued restrictive eating may lead to starvation and eventually death.

Appendicitis

Inflammation of the vermiform appendix as a result of blockage of the opening from the appendix into the cecum; the appendix wall becomes infected and ruptures, allowing the infection to spread throughout the abdomen and cause pain, anorexia, fever, nausea, vomiting, and diarrhea.

Barrett esophagus

Ectopic gastric mucosa in the lower esophagus that often becomes ulcerated leading to stricture formation

Body Mass Index

>25 = overweight, >30 = obese

Bulimia nervosa

A psychologic disorder in which recurrent binge eating is followed by intentional vomiting; inappropriate use of laxatives, enemas, diuretics, or other medication; excessive exercising; and fasting—behavior intended to compensate for overeating that has become uncontrollable.

Cholangiocarcinoma

Cancer of the bile ducts and is associated with liver flukes

Cholecystitis

Inflammation of the gallbladder commonly caused by impaction of a gallstone that causes right upper quadrant pain and possibly a rupture and abscess in the gallbladder.

Cholelithiasis

The presence or formation of gallstones in the gallbladder or bile ducts.

Cirrhosis

Degeneration of liver tissue resulting in fibrosis with nodule and scar formation that compromises liver function.

Crohn disease (CD)

An autoimmune condition in which the intestines and possibly other regions of the digestive system are chronically inflamed and ulcerated, causing chronic diarrhea, disrupted digestion, and subsequent difficulty eating and digesting food.

Cushing ulcers

Ulcers that develop as a result of severe head trauma or brain surgery (decreased mucosal blood flow)

Diverticular herniations

Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon (left)

Diverticulosis

Multiple bulging sacs pushing outward from the wall of the large intestine and may become infected and rupture, causing abdominal pain, tenderness, and fever.

Dumping syndrome

Rapid emptying of hypertonic chyme from a surgically created residual stomach causing nausea, vomiting, bleeding, and diarrhea about 20 minutes after a meal.

Duodenal ulcers

Disease characterized by epigastric pain tha tis relieved by eatiing.

Dysphagia

Difficulty swallowing

Fulminant hepatitis

A type of viral hepatitis (B, C and B+D infections ) with a high mortality rate, causes fatigue, nausea, jaundice, dark urine, flu-like symptoms, hepatomegaly, and eventually encephalopathy.

Gastrectomy

Excision of the whole or part of the stomach

Gastric Ulcer

A lesion of the antral region of the stomach, adjacent to the acid-secreting mucosa of the body

Gastrin

A protein hormone that is produced primarily in the antrum of the stomach by the G cells in response to stomach distention, vagal stimulation, the presence of partially digested proteins, and hypercalcemia and acts to stimulate parietal cells of the stomach to secrete hydrochloric acid and the chief cells to secrete pepsinogen.

Gastritis

The lining of the stomach becomes inflamed because of bacterial infection, bile reflux, or excessive consumption of alcohol or certain foods.

Gastroesophageal reflux disease (GERD)

Movement of chyme from the stomach to the esophagus

Ghrelin

Peptide hormone produced by the stomach that stimulates appaetite (levels increase before meals)

Hematemesis

Blood in vomitus

Hematochezia

Bright red or burgundy blood from the rectum

Hemolytic jaundice

Excessive destruction of red blood cells or absorption of a hematoma

Hepatic encephalopathy

Caused by liver cirrhosis and portal hypertension, toxins produced by the gut pass into the systemic circulation and damage brain cells, resulting in impaired cognition, tremor, and a decreased level of consciousness.

Hepatitis A

A virus that is spread by the fecal-oral route through contaminated food and water or by close and intimate contact and results in liver inflammation, flu-like symptoms, nausea, poor appetite, abdominal pain, fatigue, yellow eyes and skin, and dark urine that can last weeks to months.

Hepatitis B virus (HBV)

A DNA virus that is transmitted by contaminated blood or blood derivatives in transfusions, by sexual contact, or by the use of contaminated needles and instruments and may become chronic and cause long-term damage including hepatocellular carcinoma in the liver.

Hepatitis C

An RNA virus that is transmitted primarily by blood and blood products and sometimes through sexual contact and may become chronic with few to no symptoms while causing long-term damage to the liver, such as cirrhosis and hepatocellular carcinoma.

Hepatitis D

Requires Hepatitis B for replication

Hepatitis E

A virus spread via fecal-oral transmission (contaminated water) especially in developing countries

Hepatitis G

Recently discovered virus transmitted by parenteral and sexual routes

Hepatocarcinoma

Cancer that develops from liver cells and is associated with cirrhosis

Hepatorenal syndrome (HRS)

Acute renal failure occurs because of a decrease in renal blood flow secondary to liver disease characterized by decreased glomerular filtration rate and urine output (oliguria)

Hernias

Protrusion of a loop of an organ or tissue through an abnormal opening

Hyperbilirubinemia

Jaundice (icterus)

Hyperemia

An increase in the quantity of blood flow to a body part.

Ileus

Any impairment. arrest or reversal of the normal flow of intestinal contents toward the anus (blockage of the intestines)

Intussusception

An infolding or prolapse of a segment of the small intestine into the adjacent but more distal segment of the intestine.

Irritable Bowel syndrome

Functional disorder characterized by abdominal pain and altered bowel habits

Kwashiorkor

Children do not receive enough protein in their diet, resulting in a swollen and severely bloated abdomen secondary to decreased albumin in the blood, skin changes resulting in a reddish discoloration of the hair and skin in dark-skinned children, severe diarrhea, fatty liver, muscle atrophy, and restricted development.

Lactase deficiency

Not enough lactase is present in the small intestine to digest lactose, resulting in lactose intolerance characterized by diarrhea, bloating, and gas in response to exposure to lactose.

Leptin

A protein hormone produced by adipose tissue that provides the brain with an assessment of adipose mass and regulates appetite and metabolism by altering the actions of neuropeptide Y (decreases appetite)

Malabsorption

Failure of the intestinal mucosa to transport the digested nutrients

Maldigestion

Failure of the chemical process required to breakdown food

Marasmus

A childhood disorder characterized by protein and energy malnutrition, resulting in dry skin, loss of adipose tissue from normal areas of fat deposits such as buttocks and thighs, and behavior that is fretful and irritable.

Melena

Dark, tarry stools

Motility diarrhea

Decreased transit time of food through the GI tract

Neuropeptide Y

Pepetide hormone that stimulates feeding and drinking behavior

Obstructive jaundice

Extrahepatic obstruction caused by gallstones, tumor or compression from edema of pancreatitis

Occult bleeding

Blood in the feces or vomit that is not visible upon gross inspection but is detected in tests used to screen for colon cancer.

Osmotic diarrhea

Non-absorbable substance draws water into the GI tract

Paralytic ileus

Obstruction of the intestines from decreased motility

Peptic Ulcer Disease

A break or lesion in the protective mucosal lining of the lower esophagus, stomach, or duodenum

Peptide YY

A peptide hormone produced in the intestines that inhibits gastric and pancreatic secretions (decreases appetite)

Portal hypertension

An increase in blood pressure in the veins of the hepatic portal system resulting from obstruction in the liver (cirrhosis) that causes enlargement of the spleen and collateral veins.

Probiotics

Live microorganisms which when administered in adequate amounts confer a health benefit to the host

Pyloroplasty

Surgical procedure to relax the lower end of the stomach and widen the opening to the small intestine

Retching

Non-productive vomiting

Schistosomiasis

Parasitic disease caused by tremetodes (flukes) that eventually migrate to the liver

Secretory diarrhea

Excessive mucosal secretion of chloride or bicarbonate rich fluid or inhibition of sodium absorption

Steatorrhea

Fat in the stools

Steatosis

Abnormal retention of lipids within a cell (ex. hepatocytes)

Stress ulcer

Acute peptic ulcer that occurs in association with various other pathologic conditions, including burns, cor pulmonale, intracranial lesions, and surgical operations.

Strictures

Abnormal narrowing of a tubular organ (exs. blood vessels or intestines)

Ulcerative colitis

Chronically inflamed and ulcerated mucosal and submucosal lining of the large intestine, resulting in abdominal pain, diarrhea, and rectal bleeding.

Varices

Permanent dilation and lengthening of a vein

Vitamin A

Deficiency causes night blindness

Vitamin D

Increases absorption of calcium in the small intestine

Vitamin K

Cofactor for clotting cascade

Volvulus

Twisting of the intestine

Zollinger-Ellison syndrome

Increased secretion of gastrin causes excess secretion of gastric acid