Gastrointestinal System – Anatomy, Physiology & Disorders

Thirty vocabulary flashcards summarizing key anatomical structures, physiological roles, pharmacology, and major gastrointestinal disorders from the lecture notes.

Barrett's Esophagus

Key Information

• Pathophysiology/Description: Esophageal lining changes to intestinal-type cells due to chronic GERD, increasing cancer risk.
• Common Causes: Chronic GERD.
• Key Symptoms: GERD symptoms. Often asymptomatic.
• Treatment: Long-term PPIs, regular endoscopic surveillance, endoscopic ablation for dysplasia.
• Nursing Considerations: Emphasize GERD management, crucial regular endoscopy for detection, monitor symptoms.

Helicobacter pylori (H. pylori) Infection

Key Information

• Pathophysiology/Description: Spiral bacterium causing chronic gastritis and peptic ulcers.
• Common Causes: Person-to-person transmission, contaminated food/water.
• Key Symptoms: Often asymptomatic; epigastric discomfort, nausea, vomiting, or ulcer-related symptoms.
• Treatment: 10-14 day course of 2 antibiotics + PPI; bismuth sometimes added.
• Nursing Considerations: Crucial adherence to multi-drug regimen, educate on antibiotic side effects, confirm eradication post-treatment.

Gastroesophageal Reflux Disease (GERD)

Key Information

• Pathophysiology/Description: Backflow of acidic stomach contents into esophagus due to LES dysfunction.
• Common Causes: Weak LES, increased abdominal pressure, hiatal hernia, certain foods/beverages.
• Key Symptoms: Heartburn, regurgitation, chest pain, dysphagia, chronic cough.
• Treatment: Lifestyle changes (diet, elevate head of bed, weight loss), H2 blockers, PPIs.
• Nursing Considerations: Educate on lifestyle changes & diet, proper medication timing, monitor for complications.

Gastritis

Key Information

• Pathophysiology/Description: Inflammation of the stomach lining (acute or chronic).
• Common Causes: H. pylori, NSAID overuse, alcohol, stress, autoimmune factors.
• Key Symptoms: Epigastric pain, indigestion, nausea, vomiting, fullness, appetite loss; possible bleeding.
• Treatment: Address cause (H. pylori eradication, stop NSAIDs), acid suppression (PPIs, H2 blockers), antacids, dietary mods.
• Nursing Considerations: Pain management, monitor for GI bleeding, NPO/IV fluids for severe symptoms, dietary counseling.

Gastric Ulcer

Key Information

• Pathophysiology/Description: Open sore in stomach lining where acid overcomes defenses.
• Common Causes: H. pylori, chronic NSAID use. Smoking, alcohol contribute.
• Key Symptoms: Burning epigastric pain 1-2 hours after meals (not relieved by food), weight loss, nausea, vomiting; possible hematemesis.
• Treatment: H. pylori eradication, acid suppression (PPIs, H2 blockers), Sucralfate, avoid NSAIDs/alcohol/smoking; surgery for complications.
• Nursing Considerations: Pain assessment, monitor for GI bleeding (hematemesis), perforation, educate on meds, diet, stress reduction.

Duodenal Ulcer

Key Information

• Pathophysiology/Description: Open sore in the first part of the small intestine (duodenum).
• Common Causes: H. pylori (most common), chronic NSAID use. Smoking, alcohol.
• Key Symptoms: Burning epigastric pain 2-4 hours after meals or at night, relieved by food/antacids; possible melena.
• Treatment: H. pylori eradication, acid suppression (PPIs, H2 blockers), Sucralfate, avoid NSAIDs/alcohol/smoking; surgery for complications.
• Nursing Considerations: Pain assessment, monitor for GI bleeding (melena), perforation, educate on meds, diet, stress reduction.

Crohn's Disease

Key Information

• Pathophysiology/Description: Chronic, transmural inflammation of any GI segment with skip lesions. Leads to strictures, fistulas, abscesses.
• Common Causes: Genetic, immune, environmental factors.
• Key Symptoms: Abdominal pain, chronic non-bloody diarrhea, weight loss, fatigue, fever.
• Treatment: Anti-inflammatory drugs, immunosuppressants, biologics, dietary management (low-residue, high-protein), TPN, surgery for complications.
• Nursing Considerations: Pain management, monitor nutritional status, fluid/electrolyte balance, skin care (perianal), emotional support, educate on complex meds, monitor for complications.

Ulcerative Colitis

Key Information

• Pathophysiology/Description: Chronic, continuous inflammation limited to colonic mucosa.
• Common Causes: Genetic, immune, environmental factors.
• Key Symptoms: Profuse bloody diarrhea, abdominal pain, urgency, tenesmus, weight loss, fatigue.
• Treatment: Anti-inflammatory drugs, immunosuppressants, biologics, dietary management, colectomy (curative surgery).
• Nursing Considerations: Monitor stool characteristics, fluid/electrolyte balance, pain management, nutritional support, skin care (perianal), psychological support, educate on meds/complications, prepare for ostomy.

Diverticulitis

Key Information

• Pathophysiology/Description: Inflammation/infection of colon diverticula.
• Common Causes: Low-fiber diet leading to diverticulosis; infection when fecal matter traps in diverticulum.
• Key Symptoms: LLQ abdominal pain (sudden, severe), fever, nausea, vomiting, bowel changes, leukocytosis.
• Treatment: Bowel rest (NPO/clear liquids), IV fluids, antibiotics. High-fiber diet for prevention.
• Nursing Considerations: Pain meds, NPO/diet progression, monitor for worsening infection/peritonitis (rigidity, high fever), educate on high-fiber diet for prevention.

Appendicitis

Key Information

• Pathophysiology/Description: Acute inflammation/infection of the appendix.
• Common Causes: Obstruction of appendiceal lumen (fecalith, foreign bodies).
• Key Symptoms: Periumbilical pain migrating to RLQ (McBurney's point), nausea, vomiting, anorexia, low-grade fever. Sudden pain relief signals rupture.
• Treatment: Immediate appendectomy.
• Nursing Considerations: NPO, avoid analgesics until diagnosis (can mask rupture), pain assessment, monitor rupture signs (diffuse pain, rigidity), pre/post-operative care.

Pancreatitis

Key Information

• Pathophysiology/Description: Pancreas autodigestion by prematurely activated enzymes.
• Common Causes: Gallstones, excessive alcohol. High triglycerides, meds, trauma.
• Key Symptoms: Severe, persistent epigastric pain radiating to back (worsened by eating), nausea, vomiting, distension, fever. Elevated amylase/lipase.
• Treatment: Aggressive IV fluids, strict NPO (bowel rest), aggressive IV pain management, antiemetics, ERCP for gallstones.
• Nursing Considerations: Rigorous pain control, strict NPO/IV fluids, monitor fluid/electrolytes, vital signs (shock/resp. distress), assess complications, educate on avoiding alcohol/triggers, TPN if prolonged NPO.

Cholelithiasis (Gallstones)

Key Information

• Pathophysiology/Description: Hardened deposits of bile (gallstones) in the gallbladder.
• Common Causes: Bile chemical imbalance, gallbladder emptying issues. Risks: Female, Fat, Forty, Fertile.
• Key Symptoms: Often asymptomatic. Symptomatic: RUQ pain after fatty meals radiating to shoulder/back, nausea, vomiting.
• Treatment: Pain management, low-fat diet, cholecystectomy (surgical removal).
• Nursing Considerations: Pain assessment, dietary education (avoid fatty foods), monitor for complications (choledocholithiasis, cholangitis, pancreatitis), pre/post-operative care (for cholecystectomy).

Esophageal Varices

Key Information

• Pathophysiology/Description: Dilated, fragile esophageal veins due to portal hypertension, prone to rupture and fatal bleeding.
• Common Causes: Severe liver disease (cirrhosis) leading to portal hypertension.
• Key Symptoms: Often asymptomatic until rupture. Rupture: massive hematemesis, melena, hypovolemic shock (tachycardia, hypotension).
• Treatment: Acute bleeding: IV fluids/blood, vasoconstrictors (octreotide), endoscopic ligation/sclerotherapy. Blakemore tube for temporary tamponade. Prevention: beta-blockers.
• Nursing Considerations: PRIORITY: Airway protection & fluid resuscitation. Monitor vitals for shock/hemorrhage. Assess for bleeding. Blakemore tube: Keep scissors at bedside for rapid deflation if airway compression. Assist with endoscopy. Educate on prevention.