Module 5 Patho Pharm physiology only not meds

gastrointestinal, hepatic, & pancreatic disorders

GI major functions

• break down food

• absorb nutrients

• collect and eliminate waste

• Synthesize vitamins

• Produce Enzymes

• Regulate appetite

• Produce secretions aiding in digestion

Anorexia acute common causes

• common with any sudden illness

• side effect of medications

Anorexia chronic common causes

• respiratory disease (ex: COPD)

• Severe heart, kidney, or liver failure

• cancer

• AIDS

• actively dying

anorexia manifestations

• loss of appetite

• reduced appetite stimulation

• appetite suppression (ex: GLP1)

Anorexia nervosa

• restricting intentionally

anorexia complications

• chronically inflamed and sore throat

• swollen salivary glands in the neck and jaw area

• worn tooth enamel & increasingly sensitive & decaying teeth

  • associated w/bulimia

• acid reflux disorder & other gastrointestinal problems

• intestinal distress & irritation

• severe dehydration

• electrolyte imbalances

nausea

• an ill-defined and unpleasant subjective sensation

• may precede or accompany vomiting

• nausea is frequently accompanied by ANS manifestations such as watery salvation and vasoconstriction with pallor, sweating, and tachycardia

• can be caused by motion sickness, dizziness, migraine, low BG, food poisoning, severe pain, etc

• nausea may be an early warning signal of a pathologic process

Retching

• rhythmic spasmodic movements of the diaphragm, chest wall, and abdominal muscles

• may precede or alternate with periods of vomiting

• kinda like dry heaving

vomiting or emesis

• the sudden and forceful oral expulsion of the contents of the stomach

• the contents that are vomited are called vomitus

what commonly accompanies vomiting

• dizziness, light headedness, a decrease in blood pressure and bradycardia

Diarrhea

• loose and unformed bowel movements

• increased frequency and urge

causes of diarrhea

• infectious organisms

• food intolerance

• drugs

• intestinal disease

When is diarrhea an emergency

• dehydration/ electrolyte imbalance

• infants

• bloody diarrhea, high fever, signs of toxicity

diarrhea treatment

• primary: replacement of fluid & electrolytes

• dietary: bland or mild foods, nothing high in sugars or spicy

• medications: diphenoxylate (lomotil) and loperamide (Imodium)

  • if bacterial - dont want to prescribe bc want to get out of the system

Constipation

• difficulty emptying the bowels

  • primary disorder of intestinal motility

  • secondary problem (associated with another disease/condition)

common causes of constipation

• failure to respond to the urge to defecate

• inadequate fluid intake

• inadequate fiber in the diet

• weakness of the abdominal muscles

• inactivity and bed rest

• side effect of drugs: narcotics/pain meds

• pregnancy

• hemorrhoids

• symptom of obstructing lesions of the GI tract

constipation treatment

• directed toward relieving cause

• dietary: directed toward relieving cause, increase fluid, fiber, and activity

• medications: laxatives & enemas used judiciously

  • they should not be used on a regular basis bc they interfere with defecation reflex and can damage rectal mucosa

Gastritis

• inflammation of the stomach lining, can be acute or chronic

Causes of gastritis

• diet and lifestyle

  • ETOH

  • smoking

  • stress

  • long term NSAID use

common manifestations of gastritis

• stomach pain

• belching

• nausea

• vomiting

• abdominal bleeding

• feeling full

• blood in vomit or stool

Gastroesophageal Reflux Disease (GERD)

• Back flow of gastric contents into the esophagus

Etiology of GERD

• Inappropriate relaxation of the lower esophageal sphincter

• hiatal hernia

Symptoms & complications of GERD

• heartburn

• Epigastric pain

• respiratory issues

• esophagitis

• long term exposure to stomach acid → esophageal cancer

Risk factors of GERD

• lifestyle: smoking, overweight & obesity

• increased abdominal pressure: weight, pregnancy, tight clothes over eating

GERD Treatment

• avoid irritants:

  • large meals

  • fatty/fried/spicy foods

  • citrus

  • peppermint

  • chocolate

  • caffeinated drinks (coffee)

  • ETOH

• sleep with head of bed elevated

GERD medications

• antacids

• inhibitors of gastric acid secretion

  • PPI: omeprazole (Prilosec), esomeprazole (Nexium), Lansoprazole (Prevacid), Pantoprazole (Protonix)

  • H2 Blockers: Famotidine, (Pepcid), cimetidine (Tagamet)

Peptic Ulcer Disease

• peptic ulcers can occur in the stomach (gastric) or duodenum (duodenal)

• ulcer development that can affect one or all layers of the stomach or duodenum → healing often results in scar tissue formation

Peptic Ulcer Disease Etiology

• H. pylori

• Medications (NSAIDs, ASA)