Gastrointestinal Disorders

Osmotic diarrhea

Increased amount of poorly absorbed solute in the intestines (ex. Excessive carbs or magnesium)

Exudative diarrhea

Ex. Mucus, Blood, Protein in poop. Results from inflammatory processes

what disease process would you see Exudative diarrhea?

crohn disease or ulcerative colitis

Motility disturbances diarrhea

Decrease contact time of chyme ( digestive contents) With the Absorptive surfaces of the intestinal lumen. that is an inadequate absorption of chyme

If diarrhea is caused by a bacteria what kind of diarrhea is it?

Secretory (Infectious) Diarrhea

Diarrhea

Increase frequency and fluidity of bowel movements caused by decrease transit time in the small intestines (Increase peristalsis)

When intestinal obstruction causes constipation

The process decreases the motility (Peristalsis) Of the G.I. tract

signs and symptoms of Constipation

Small, Infrequent, hard, Or difficult bowel movements; Fewer than three stools/ Week

Etiology of constipation

G.I. tract related, does not occur in the stomach; could be related to dietary/ Lifestyle or Pathologic; Can be managed with medications or magnesium, fiber, and caffeine

stomatitis

Ulcerative inflammation of the Ora mucosa (buccal, lips, palate)

Ulcerative inflammation of the oral muscoa (lip, palate, buccal); caused by viral, chemical exposure, chemo or radiation is the etiology of what?

Stomatitis

This is a type of stomatitis

Acute Herpetic Gingivostomatitis

Signs and symptoms of stomatitis

Cold sores, fever, vesicular lesions

What lies latent in the dorsal ganglia of the spinal cord and reactivated by stress

Viral stomatitis

Acute Herpetic Gingivostomatitis

Cold sore

Signs and symptoms of acute herpetic gingivostomatitis

Fever, pharyngitis (sore throat from viral or bacterial infection), prodromal tingling and itching (in area before it breaks out), vesicles on a erythematous base that ruptures leaving a painful ulcer

Patho of Gastroesophageal Reflux Disease

Any condition that weakens the closure strength and efficacy of the lower esophageal sphincter (LES) or increase intraabominal pressure

Clinical manifestations of Gastroesophageal Reflux Disease

Reflux esophagitis (inflammation of the lining of the esophagus), Chest pain, burning in throat, dysphagia, chronic condition can cause Barrett’s esophagus

Complications of GERD

Ulceration, scarring, esophageal strictures, pulmonary symptoms (aspiration or near- aspiration).

Etiology of GERD

Multi factorial, anything that inhibits the closure of te esophageal sphincter (fatty foods, tight fitting clothing, certain sleep positions, smoking)

Clinical manifest of hiatal hernia

Heartburn, chest pain, and dysphagia

Explain what’s going on when someone has a hiatal hernia

Part of the stomach passes over the diaphragm opening

Risk factors for hiatal hernia include

Pregnancy and excessive coughing

Etiology of Gastroesophageal varies

Portal hypertension (vein that carries blood from the preen and the small intestine to the liver); manageable until rupture

Signs and symptoms of Gastroesophageal varies

Vomiting blood (hematemesis); Melena (dark, tarry stools), anemia, shock

First distinct phase of variceal hemorrhage

Coinciding with in shortly after the bleeding greatest risk of rebleed occurs in first 72 hours

Second distinct phase variceal hemorrhage

Period of 6 to 8 weeks following initial bleed

Gastritis

Inflammation of the stomach lining, typically acute caused by virus alcohol or H. pylori

Clinical manifestations of gastritis

May be asymptomatic, anorexia, nausea, vomiting, postprandial discomfort, hematemsis

Gastroenteritis

Inflammation of the stomach lining and small intestines can be acute viral or chronic with chronic illness

Clinical manifestations for gastroenteritis

Abdominal discomfort, diarrhea, nausea, vomiting

Etiology of peptic ulcer disease

Breakdown of epithelial cells in the upper GI tract (primarily stomach lining)

Gastric ulcers

The surface of the mucosa can be stripped away from substance, such as aspirin, NSAIDs, Alcohol and bile acid, causing degeneration of the epithelial cell Membranes. This allows acid to diffuse into gastric epithelium

Clinical manifestation of gastric ulcers

Pain may occur with/soon after eating, eating triggers, production of additional G.I. juices

Major risk factor for ulcer formation

H pylori

Clinical manifestation of peptic ulcer disease

Burning mid Epigastric pain on an empty Stomach, dyspepsia (Upset stomach), hematemesis

If a patient is asymptomatic to a G.I. bleed and has melena, what should they do?

Notify healthcare provider

Duodenal ulcers

Inappropriate secretion of acid into the duodenum (Small intestine)

Clinical, manifestation of duodenal ulcers

Pain occurs 2 to 3 hours after a meal once stomach contents empties into the duodenum

When does pain occur when a patient has an epigastric peptic ulcer disease?

Burning pain just after eating or durning

Clinical manifestations of peptic ulcer disease

Hematemesis, burning, mid-epigastric pain, pain with empty stomach, dyspepsia

When does a patient experience pain with duodenal peptic ulcer disease?

Pain occurs 2-3 hours after eating (once stomach is easy)

When you see this clinical manifestation in peptic ulcer disease, you need to notify the doctor

Melena

Two types of inflammatory bowel disease

Ulcerative colitis and Crohn’s disease

Pathology of ulcerative colitis

Begins as inflammation at the base of the crypts of Lieberkühn. Leads to the formation of abscesses in the epithelial of the crypts; Caused by an invasion Of leukocytes;

Where does ulcerative colitis affect?

Just the colon

Where does ulcerative colitis start and go?

Starts in rectum and moves upwards

Clinical manifestations of ulcerative colitis

High vascularization of granulation tissue Causes bloody diarrhea, lower abdominal pain and rectal bleeding

Complications of ulcerative colitis

Toxic megacolon and colon cancer

Toxic megacolon

becomes distended and dilated to the point it cannot move gas or feces. These buildup in can cause intestinal rupture.