Gastrointestinal Tract, GERD, Peptic Ulcers, and GI Disorders: Key Concepts and Treatments

What is the major function of the gastrointestinal (GI) tract?

Convert complex compounds into simpler compounds that can be absorbed and used by cells.

What is GI transit time?

The time it takes material to pass from one end of the GI tract to the other.

What happens when GI transit time speeds up?

Less absorption occurs.

What happens when GI transit time slows down?

More absorption occurs.

What three substances are secreted by stomach glands?

Enzymes, hydrochloric acid, and mucus.

What is GERD commonly called?

Heartburn.

Name three symptoms of GERD.

Burning chest pain, acid taste, recurrent abdominal pain.

Name four factors that contribute to GERD.

Pregnancy, overeating, alcohol use, smoking.

What are the three major medication groups used for GERD?

Antacids, H2 antagonists, and proton pump inhibitors (PPIs).

What do H2 antagonists do?

Block gastric acid and pepsin secretion.

What is the most important dose time for H2 antagonists?

Bedtime.

Name four H2 antagonists.

Cimetidine, famotidine, nizatidine, ranitidine.

What do proton pump inhibitors do?

Inhibit the hydrogen-potassium pump in parietal cells and block acid secretion.

Name five PPIs.

Omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole.

When should omeprazole (Prilosec) be taken?

Before meals.

What is the primary side effect of omeprazole?

Diarrhea.

Which PPI is commonly used in hospitals because it has an IV form?

Pantoprazole (Protonix).

What coating agent is used for GERD?

Sucralfate (Carafate).

What are the three common ulcer types?

Gastric, duodenal, and stress ulcers.

Which bacteria causes most peptic ulcers?

Helicobacter pylori (H. pylori).

What is the main treatment for H. pylori?

Antibiotics combined with an antacid or PPI.

Name four antibiotics used to treat H. pylori.

Amoxicillin, clarithromycin, metronidazole, tetracycline.

ICU patients often receive what drug class to prevent stress ulcers?

H2 antagonists.

What is gastritis?

Irritation and superficial erosion of the stomach lining.

What is a common cause of gastritis?

Alcohol (ETOH).

What is ulcerative colitis?

An inflammatory bowel disease affecting the large bowel.

What is Crohn's disease?

An inflammatory bowel disease that can affect any part of the GI tract.

Can Crohn's disease be cured by surgery?

No.

What drug is a pancreatic enzyme replacement?

Pancrelipase (Creon, Pancrease, Viokase).

What drug is used for active Crohn's disease and rheumatoid arthritis?

Infliximab (Remicade).

What drug promotes GI motility and acts as an antiemetic?

Metoclopramide (Reglan).

Why is diarrhea dangerous?

It can quickly cause dehydration.

Name four antidiarrheals.

Pepto-Bismol, Lomotil, Imodium, Xifaxan.

What schedule drug is Lomotil?

Schedule V narcotic.

How does loperamide (Imodium) work?

Decreases intestinal peristalsis.

Why should antidiarrheals be avoided in infectious diarrhea?

They keep pathogens in the body longer and prolong fever.

What is fiber?

Undigested residue of plant foods.

What are two benefits of fiber?

Prevents constipation and lowers cholesterol.

What is the maximum recommended fiber intake per day?

40 g/day.

Name three adverse effects of excess fiber.

Distention, gas, flatulence.

How much water should people drink to help prevent constipation?

6-8 glasses per day.

What type of laxative is lactulose?

Osmotic laxative.

What type of laxative is bisacodyl (Dulcolax)?

Irritant/stimulant laxative.

What type of laxative is psyllium (Metamucil)?

Bulk-forming agent.

How should psyllium be taken?

With a full glass of water.

What bowel evacuant is commonly used before GI procedures?

Polyethylene glycol (GoLYTELY, MiraLax).

What does CTZ stand for?

Chemoreceptor Trigger Zone.

Where is the vomiting center located?

Medulla.

Name three complications of vomiting.

Dehydration, electrolyte imbalance, aspiration pneumonia.

What is vertigo?

Sensation that the room is spinning.

Name four antiemetics.

Ondansetron, promethazine, meclizine, metoclopramide.

What is the most widely used antiemetic?

Promethazine (Phenergan).

How does ondansetron (Zofran) work?

Blocks serotonin receptors.

What is the major side effect of ondansetron?

Headache.

What is the IBW formula for males?

50 + (2.3 × inches over 5 feet).

What is the IBW formula for females?

45.5 + (2.3 × inches over 5 feet).

What is BMI used for?

To determine appropriate obesity treatment.

To lose 1 pound, approximately how many calories must be reduced?

3,500 calories.

What is the first weight lost during dieting?

Retained water.

What is the most important behavior modification for weight loss?

Exercise.