gastro everything

diagnostic gastro tests

1. xray

2. endoscopic exam (look into digestive organs with a endoscope)- ex. gastroscopy (endoscopy of stomach)

3. GI series (upper GI series and Lower GI series)

4. upper gi series:barium swallow to examine esophagus, stomach, and upper small intestine)

5. lower gi series: barium enema'

6. occult blood: examines stool for blood hidden in stool. positive test might mean colon cancer

7. ova/parasites: examines stool for specimen for parasites/eggs

Barium swallow (more of upper gi series)

• special type of imaging test using barium and Xray

• patient drinks thick, chalky liquid

• radiologist uses fluoroscopy (moving xray) as it moves thru throat and esophagus

• diagnose issues with swallowing, blockages, narrowing and growths

lower gi tract (colon)/barium enema

• xray diagnostic procedure examining large intestine using contrast liquid containing barium

• barium filled tube inserted into rectum to coat colon, xray are taken to identify abnormalities (ulcers, polyps, and cancer)

video capsule endoscopy

• capsule containing a miniature video camera to travel thru small intestine

• sends images to receiver

Mouth Diseases:dental caries

• diseases of teeth due to bacteria on tooth surface (affecting childen/young adults)

• -from bacteria and diet high in COHs

• produce plaques/cavities

• -dental plaque sticky film forming on teeth due to constant presence of bacteria in mouth from feeding on sugars

• -process creates an acidic byproduct combines with saliva to form film

• -poor oral hygiene

• prevention: regular brushing/flossing

caries vs cavities

• tooth decay (process happens over time)

• cavity (resulting hole in tooth if decay is left untreated)

• caries= diseases; cavities=symptoms

Mouth Diseases: periodontal disease (what it is, symptoms, diagnosis, prevention, treatment)

• affects supporting structures of teeth, starting at gums, then to bone and ligament destruction

• causes: dental plaque, poor oral hygiene, inadequate doet

• symptoms: dental plaque, may lead to gingivitis

• diagnosis/treatment: inspect depth of teeth, redness

• prevention: regular brushing/flossing

4 periodontal disease stages

1. plaque accumulates near gums

2. gums become inflamed (gingivitis)

3. pockets form, bacteria spreads (early peridonitis)

4. bone loss, loose teeth, potential tooth loss (advanced periodonitis)

Mouth Diseases: Mouth cancer (where it occurs, causes and treatment)

• can occur on lip, cheek, palate/tongue

• common oral cancer (SCC)

• lower lip from exposure to sunlight, chewing tobacco or smoking

• treatment: radiation/surgical excision

Diseases of Esophagus:reflux esophagitis

• inflammation of lower end of esophagus (commonly caused by GERD)

• Cause: GERD, condition, stomach contents reflux through cardiac sphincter into esophagus

• most common symptom: -heartburn

• treatment for reflux: avoid large meals

• dietary changes

• sleep on left side

• medications (antacids, laxatives and stool softeners)

Diseases of Esophagus: esophageal varices (causes, what it is and symptoms)

-dilated varicose veins in esophagus

-enlarged veins relating to blockage of blood flow into liver, any condition leading to venous congestion (portal hypertension) in liver can lead to esophageal varices

-mostly related cirrhosis of liver (common cause is excessive alcohol consumption)

symptoms: hematemesis (vomiting of blood), black stools and dilated esophageal blood vessels)

more of treatment for esophageal varices (treatment and complications)

• limit diet to soft foods, use of stool softeners to prevent straining (this increases esophageal venous pressure), sclerosing agents hardening vessels, and avoid alcohol

• complication: rupture leading to hemorrhage, can be life threatening

diseases of esophagus: Bleeding from esophageal varices (treatment for bleeding)

1. bleeding from esophageal varices is life threatening caused by swollen veins in esophagus (high pressure in portal vein system)

2. intravenous fluids, meds for pressure, endoscopic procedure to stop bleeding by banding varices or injecting drug to constrict

3. can use balloon tamponade as temporary procedure to apply direct pressure to hemorrhaging vessels, balloon inflated thru a catheter in nose

diseases of stomach: gastritis (causes, H pylori, symptoms and diagnosis)

• stomach inflammation

• causes: irritating agents- NSAIDs, alcohol, smoking

• infection with helicobacter pylori- bacteria found in stomach lining

• bacteria weakens protective lining of stomach, leads to ulcers

• unknown why H. pylori causing ulcers in some/not others

• Common symptoms: abdominal pain, nausea/vomiting and belching

• diagnosis: urea breath tests, stool antigen test, upper Gi endoscopy

diseases of stomach: peptic ulcer (causes)

• found in stomach (gastric ulcers) and duodenum (duodenum ulcers)

• often caused by H. Pylori

• or caused in part by pepsin (enzyme secreted by stomach that breaks down protein, and break down stomach protective lining causing ulcers)

• Other causative factors, stress, smoking, aspirin, alcohol

diseases of stomach: peptic ulcer (treatment)

• eradication of H. Pylori requiring combo therapy

• proton pump inhibitor (decreases acid production), plus two antibiotics (clarithromycin and amoxicillin) to eliminate bacteria

• possible surgery

diseases of stomach: gastric ulcers vs duodenal ulcers

• main difference in symptoms between both is timing of pain

• gastric ulcers: pain 1-2 hours after eating

• duodenal ulcers: pain 2-4 hours after eating, while food may relieve pain of duodenal ulcers, and pain at nighttime

• shared symptoms: burning, pain upper abdomen, bloating, nausea and bloody stools

• both can be caused by H.Pylori/NSAIDS

diseases of stomach: revealing stomach ulcers

• gastroscopy

• barium swallow reveal gastric ulcers in pyloric antrum

Diseases of small intestine: malabsorption syndrome (causes)

• small intestine unable to absorb nutrients

• difficulty absorbing fats, COHS (celiac disease), proteins, or vitamins

• celiac disease: gluten induced enteropathy treated by removing gluten from diet

Diseases of small intestine: malabsorption syndrome (prevention, treatment and complications)

• often hereditary, no preventative solutions

• genetic screening followed by routine exams/testing

• treated by diet therapy to control doncition

• complication: bleeding tendency from lack of vitamin K absorption

Diseases of small intestine: regional enteritis (crohns disease).. what it is

• inflammatory bowel disease

• known as a chronic inflammatory disease affecting small intestine, but could affect large intestine

• patchy, transmural inflammation of GI tract

Diseases of small intestine: crohns disease (characterized by, symptoms, and diagnosis)

• bouts of remission (slowing or stopping of symptoms), and flaring of symptoms

• unknown etiology

• symptoms: anorexia, flatulence, abdominal pain, diarrhea and constipation

• diagnosis: imaging studies (CT scan, colonscopy and video capsule)

Diseases of small intestine: inguinal hernia (causes and symptoms and treatment)

• outpouching of small intestine and peritoneum into groin area

• main cause: weakness in abdominal wall (combined with pressures from heavy lifting, chronic coughing or straining)

• weakness can be congenital, or develop over time from aging, obesity and other abdominal strains muscles

• symptoms: bulge in groin area with pain increasing bending or lifting, relieved by lying down

• treatment: surgical repair

Diseases of small intestine: inguinal hernias more common in males vs females

• presence of inguinal canal traversed by testicles during fetal development

• can leave a permanent weak spot/opening in abdominal wall where spermatic cord passes, making it more susceptible to hernia

• herniated bowel may become caught and twisted (strangulated/ischemic bowel)

• in females, inguinal canal is narrow and stronger ligament supporting uterus (less likely to develop hernia)

Diseases of colon:treatment

• may require surgical resection

• hemicolectomy: removal of half of colon

• anastomosis: connects two healthy colons ends together

• colectomy: removal of entire colon

• colostomy: temporary/permanent opening in colon if anastomosis isnt possible

• stoma: colon opening in abdominal, will excrete feces (one and two piece appliances, ostomy bags)

Diseases of colon: appendicitis (symptoms and treatment)

• inflammation of appendix

• symptoms:

• -pain from appendicitis starts as dull ache near belly button shifting to lower right side of abdomen (severely)

• nausea/vomiting

• fever

• leukocytosis

• surgical excision (before peritonitis occurs)

Diseases of colon:ulcerative colitis (causes and symptoms)

• chronic inflammation of colon causes inflammation/ulcers in rectum and colon lining

• UC found in large intestine, while crohns found in small intestine

• unknown etiology

• symptoms: lower abdominal pain, bloody stools, anemia and diarrhea

ulcerative colitis (diagnosis and treatment)

• diagnosis: stool sample, CT scan, colonoscopy

• treatment: dietary limitations, stress reduction, sedatives, anti-inflammatory meds, may need permanent colostomy

crohns vs ulcerative colitis

• age of onset: 15-35 vs 55-70 yrs

• symptoms of crohns: dependent on location, abdominal pain, diarrhea, weight loss

• symptoms of UC: stool urgency, increased bowel movements, mucous in stool

• bloody stool more common in UC

• malnutrition more common in crohns

Diseases of colon: diverticulosis/diverticulitis

• condition of diverticula (little pouches) in colon

• forms when weak spots in colons wall bulge out, caused by high pressure inside intestine, leading to constipation

• risk factors: low fiber diet, lack of exercise,obesity, smoking and certain meds

• diverticulitis-out pouches become packed with fecal material (become inflamed)

symptoms of diverticulitis

• low abdominal pain

• cramping

• inflammation progresses- possible hemorrhage, narrowing of colon lumen

• diagnosis: colonoscopy

• treatment: increase fiber in diet, antibiotics

diverticulosis: who does it affect

• common condition that affects ½ of Americans over 60

• nearly everyone affected by age 80

• usually may not cause symptoms

Disease of colon: colon polyps (how it forms, risk factor and treatment)

• small growths on inner lining of colon/rectum

• form by abnormal cell growth (genetic mutations)

• MAJOR RISK: family history

• some types can become cancerous

• treatment: removal during colonoscopy to prevent colorectal cancer

diagnosis of colonscopy/sigmoidscopy

• excisional biopsy of suspicious polyps

• polyps might not be preventable

• maintain healthy lifestyle

diseases of colon: villous adenomatous polyp (characteristics, symptoms, and treatment)

• type of growth in colon/GI tract, having high risk of becoming cancerous

• symptoms: rectal bleeding, changes in bowel (constipation/diarrhea), mucus in stool

• often are (sessile/flat/broad)

• treatment: colonoscopy

diseases of rectum: hemorrhoids (what it is and causes)

• varicose veins in rectum

• internal vs external hemorrhoids

• internal:located on rectal wall, use anoscope (examine anus) or proctoscope (examines rectum)

• external: located external around anus, might bleed during bowel movement strain

• causes: constipation/straining, prolonged sitting, and pregnancy

diseases of rectum (diagnosis, symptoms and treatment, prevention)

• diagnosis: external hemorrhoids diagnosed with physical exam

• symptoms: itching, bleeding, rectal pain

• treatment: meds, sitz bath, hemorrhoidectomy

• prevention: adequate fluid intake, exercise and avoid laxatives ( irritates hemorrhoids)