GI motility

What is gastroparesis?

Delayed stomach emptying.

What are the common symptoms of gastroparesis?

Nausea, vomiting, constipation, or diarrhea.

What metabolic problem can gastroparesis cause?

Changes in blood glucose.

What disease is commonly associated with gastroparesis?

Diabetes mellitus.

What nerve-related condition can cause gastroparesis?

Autonomic neuropathy.

what happens to gastric smooth muscle contractility?

The normal contractions of the stomach muscles are altered.

What other system can be affected in gastroparesis?

The enteric nervous system.

What happens to gut hormones in gastroparesis?

Gut hormones can be altered.

What changes can occur in the pyloric sphincter in gastroparesis?

Changes in tonic contraction and transient relaxation.

What nerve control can be lost in gastroparesis?.

Vagal control

What can cause disorders of the enteric nervous system gastroparesis?

Diabetic neuropathy and surgical resection.

What hormone is associated with gastroparesis?

Motilin.

What can develop in patients with gastroparesis?

Bezoars (masses of undigested material in the stomach).

How can gastroparesis affect blood glucose control?

It can cause erratic (unpredictable) blood glucose levels.

How can gastroparesis affect body weight?

It can cause weight loss.

What is cholelithiasis?

The presence of gallstones in the gallbladder.

- most common gallbladder disorder

What is bile made up of in gallbladder disorders?

Bile contains cholesterol.

What happens when cholesterol becomes too concentrated in bile?

It falls out of solution and forms crystals.

What happens when gallbladder emptying decreases?

Bile stays in the gallbladder longer.

Why does bile staying in the gallbladder longer contribute to gallstones?

It has more time to mix with cholesterol.

What is lithogenesis?

The process of gallstone formation.

What is cholecystitis?

Inflammation of the gallbladder.

What serious condition can cholecystitis progress to?

Acute pancreatitis.

How can gallstones cause acute pancreatitis?

Stones in the common bile duct can move and block the pancreatic duct.

What can happen if the gallbladder becomes infected?

It can lead to serious complications.

What is infarction?

Loss of blood supply to tissue.

What is necrosis?

Death of tissue.

What life-threatening complication can result from an infected gallbladder?

Sepsis.

What are common disorders of the small intestine and colon?

Diarrhea, inflammatory bowel disease (IBD), and diverticular disease.

What changes in the digestive system can cause diarrhea?

Altered motility, secretion, digestion, or absorption.

What diseases outside the intestines can contribute to diarrhea?

Diseases of the stomach, pancreas, and biliary tract.

What are the clinical signs of diarrhea?

Increased stool frequency, increased stool volume, and decreased stool consistency.

with diarrhea - What causes the changes in stool consistency?

Changes in water absorption.

What is acute diarrhea usually caused by?

Infections.

What is another possible cause of acute diarrhea?

Medication side effects.

What are other causes of diarrhea?

Water malabsorption, decreased absorption, or increased secretion.

What is osmotic (malabsorption) diarrhea?

Diarrhea caused by nutrients that are not properly absorbed.

What causes osmotic diarrhea?

Malabsorbed or poorly absorbed nutrients.

What pancreatic problem can cause osmotic diarrhea?

Pancreatic insufficiency.

How can damage to enterocytes cause diarrhea?

Damaged enterocytes decrease nutrient absorption.

What is secretory diarrhea?

Diarrhea caused by increased fluid secretion into the intestines.

What happens to fluid secretion in secretory diarrhea?

The rate of fluid moving out of cells increases.

Does secretory diarrhea stop when a patient fasts

No, it continues even when the patient is fasting.

What causes excessive osmotic load in the intestines?

Direct ingestion of osmoles or ingestion of substances converted into osmoles.

what can contribute to osmotic diarrhea

bacterial action, lactose and enzymatic disease

What causes an increase in intestinal secretion?

An increase in blood-borne or intraluminal secretagogues.

What is a secretagogue?

A substance that causes another substance to be secreted.

What type of toxins can cause secretory diarrhea?

Exotoxins (such as those involved in food poisoning).

What luminal substance can cause secretory diarrhea?

Bile acids.

How can alcohol cause diarrhea?

Through its toxic effects on the intestines.

How can infectious agents cause diarrhea?

They damage the intestinal mucosa (lining).

What are prokinetic agents?

Medications that speed up GI motility.

How can inflammatory disorders contribute to diarrhea?

They can cause loss of blood, mucus, and protein.

What are common infectious causes of diarrhea?

Infectious agents.

How can bacterial toxins cause diarrhea?

They alter normal intestinal function.

Where can invasive organisms cause infection?

They can invade and remain localized to the colon.

What are the clinical manifestations of diarrhea?

Dehydration, malnutrition, weight loss, and vitamin deficiency.

What are common symptoms of IBD?

Abdominal pain with diarrhea and/or constipation.

What parts of the digestive tract can IBD affect?

The small intestine and colon. - chronic disease

What is a prominent feature of IBD?

Malabsorption (poor absorption of nutrients).

How is inflammatory bowel disease (IBD) distinguished from infections?

By ruling out other possible causes first (diagnosis by exclusion).

What are the main characteristics of IBD?

Recurrence, mucopurulent (mucus and pus) bloody diarrhea, negative cultures, and failure to respond to antibiotics.

What is the pattern of IBD symptoms?

Exacerbations (flare-ups) followed by remission (periods when symptoms improve).

What environmental factors may contribute to Crohn’s disease?

Pathogenic microorganisms, viruses, bacteria, microbes, smoking, diet, and psychological factors.

What role does the immune system play in Crohn’s disease?

Immune system activity and inflammation are involved.

What are the main environmental factors associated with Crohn’s disease?

Microorganisms, smoking, diet, and psychological factors.

Where is Crohn’s disease commonly located?

In the distal ileum and colon.

How does inflammation occur in Crohn’s disease?

In discontinuous areas, meaning there are patches of inflammation and ulceration with normal areas in between.

How deeply does Crohn’s disease affect the bowel wall?

It involves the entire thickness of the bowel wall.

What causes the cobblestone appearance in Crohn’s disease?

Deep mucosal ulceration and submucosal thickening.

What are the complications of Crohn’s disease?

Perforations, small intestine obstruction, frank bleeding, and protein loss.

Can Crohn’s disease cause symptoms outside the GI tract?

Yes. It can affect other parts of the body.

What joints or organs can be affected by Crohn’s disease?

Joints (arthritis), skin, eyes, mucosal membranes, bile ducts, and kidneys.

What type of joint inflammation can occur with Crohn’s disease?

Arthritis.

What part of the digestive tract does ulcerative colitis affect?

The mucosa (inner lining) of the colon and rectum.

How is ulcerative colitis similar to Crohn’s disease?

They have similar symptoms and presentations.

How is ulcerative colitis different from Crohn’s disease?

It has limited or no obstructions, perforations, or fistulas.

What are two important features of ulcerative colitis?

Pseudopolyps and an increased risk of adenocarcinoma.

What are the symptoms of diverticular disease according to the slide?

Abdominal pain with diarrhea and/or constipation.

What type of process is listed on the slide?

A chronic autoimmune process.

What parts of the digestive tract are listed?

The small intestine and colon.

What is a prominent feature listed on the slide?.

Malabsorption (poor absorption of nutrients)

What is diverticular disease?

Having diverticula (small outpockets) in the colon.

How do diverticula form?

The colonic mucosa pushes outward through weak areas in the muscle layer.

What are symptoms of uncomplicated diverticular disease?

Cramping, flatulence (gas), and irregular bowel movements.

Why can uncomplicated diverticular disease be difficult to distinguish?

It can be hard to separate from irritable bowel syndrome (IBS).

What are complications of diverticular disease?

Rapid bleeding, slow bleeding that causes anemia, and infected diverticula that can develop into abscesses.

Why is complicated diverticular disease dangerous?

It can cause serious bleeding or infection.

What percentage of people with diverticular disease are asymptomatic?

About 80%.

What is a common exception to being asymptomatic?

Constipation.

What type of abdominal pain can occur

Intermittent, unpredictable, gripping pain in the lower abdomen.

What are other possible symptoms of diverticular disease?

Fever and sometimes bleeding, including bloody stool.

What signs of peritoneal irritation may be present?Diverticular Disease

Guarding, rebound tenderness, and abdominal tenderness.

What might be heard with a stethoscope during examination?Diverticular Disease

Absent bowel sounds.

What culture finding is listed on the slide?Diverticular Disease

Positive blood culture.

Where does diverticular disease usually occur?

In the colon (about 90% of cases).

What is a common cause or contributing factor to diverticular disease?

Chronic constipation.

How can diet contribute to diverticular disease?

Eating highly refined foods that are low in fiber.

What is diverticulosis?

The formation of diverticula (small pouches) in the colon.

Where does diverticulosis most commonly occur?

In the descending and sigmoid colon.