Med Surg Exam 3 GI

GERD

stomach acids travel up the esophagus, causing irritation to esophageal lining

causes of GERD

food choices; spicy, caffeine, alcohol, chocolate, citrus; lifestyle factors, low socioeconomic status, laying down after eating, medications that relax LES

GERD s/s

heartburn, chest pain, regurgitation, sour taste, dysphagia, belching, nausea

treatment for GERD

reduce risk factors, medications; H2 blockers, PPIs, antacids, anticholinergics, mucosal protectants, pro kinetics , surgery

ulcerative colitis

chronic inflammatory disease that affects the large intestine (colon + rectum)

s/s of ulcerative colitis

diarrhea (electrolyte loss), abdominal pain/distention, fever, fatigue, weight loss, rectal bleeding, nocturnal MB

diagnosis for UC

H/H, electrolytes, ESR, WBC, C-reactive protein (increased), colonoscopy (show ulcerations + inflammation of sigmoid colon +rectum)

treatment of UC

NPO, high protein high calorie diet, avoid trigger foods, avoid NSAIDs, %-aminosalicylate, corticosteroids (reduce inflammation), immunosuppressants, antidiarrheals

complications of UC

increased risk of colon cancer, bowel obstruction/perforation, peritonitis, fluid and electrolyte imbalances

Crohn’s disease

long term IBD causes inflammation and ulcers anywhere in the digestive tract, from mouth to anus

s/s of crohn’s

rectal bleeding, diarrhea, cramping/abdominal pain, weight loss, fever, fatigue, steatorrhea, increased risk of anal fissures, bowel obstructions,

treatment for crohn’s

same as UC NPO, high protein high calorie low fiber, avoid trigger foods, avoid NSAID, 5- aminosalicylate, corticosteroids, immunosupresants, antidiarrheals

constipation

infrequent bowel movement (less than 3/week) that are hard to pass

causes of constipation

inactivity, low fiber or fluid intake, ingnoring urge, laxative overuse, travel or routine changes, meds= opioids, antacids, anticholinergics, antisezure, diuretics, iron, anti-parkinson, antidepressants

treatment of constipation

increase fiber, fluids, probiotics, exercise, bowel training, stool softness, enema, laxative, provide privacy

diarrhea

frequent, loose stools

causes of diarrhea

infections, meds= ABX, magnesium-containing antacids, GI disorders, diet= coffee, alcohol, fried foods, spicy foods, lactoset

treatment of diarrhea

remove irritation factor, rehydration, OTC meds, ABX for infection, low fiber diet

voncomycin

c diff, nephrotic med loss of BUN/creatinine (0.5-1.3)

colostomy

surgical opening into large intestine to drain stool

ileostomy 

less formed stools/liquidy; placed in colon (large intestine)

intestinal obstruction

contents can not pass through the intestines

partial obstruction

passing some stool; total= passing no stool

4 hallmark s/s of obstruction

abdominal pain, N/V, distention, constipation, high-pitched and hyperactive above area of obstruction → absent

diagnostic of intestinal obstruction

abdominal x-ray or CT, contrast enema, followed by CBC ( increased H/H, BUN, creatinine- dehydration)

gallbladder obstruction risk factors

obesity, older than 40, women, sedentary lifestyle, multiple children

s/s of gallbladder obstruction

dark amber urine, clay-colored stools, steatorrhea, pain, jaundice, purities, intolerance to fatty foods

partial obstruction s/s

still passing some type of stool, vomiting diarrhea

total obstruction s/s

N/V, terrible abdominal pain, cannot pass stool

peptic ulcer

erosion of the mucosal lining of the stomach, esophagus, duodenum

cause of peptic ulcer

H. pylori, NSAIDs, corticosteroid use, stress, alcohol

s/s of peptic ulcer

dyspepsia (heartburn), abdominal pain or tenderness, distention, board-like abdomen, tachycardia, HYN

treatment of peptic ulcer

decrease risk factors, medications (PPIs, antacids, mucosal protectants, ABX-H pylori,), surgery

endocscopy

upper GI (mouth, esophagus, stomach, duodenum)→ GERD, peptic ulcer, stomach cancer

colonoscopy

lower GI (large intestine, colon, rectum ,appendix, anus)

GI bleed

massive- 1500 ml or greater, once high have risk for having another

s/s of slow GI bleed

nausea, abnormal bowel sounds, dark stools, H/H slightly below baseline

upper GI bleed

stomach + duodenal origin- PUD

s/s of upper GI bleed

hematemesis (bright red or coffee ground vomit), melon (black, tarry stools), abdominal pain + fidgety, nausea

lower GI bleed s/s

bright red stools t

treatment of GI bleed

blood transfusion if hemoglobin below 7, no aspirin, clear liquids

irritable bowel syndrome

chronic disease that causes inflammation in digestive tract

diet for IBS

avoid foods that trigger (dairy, wheat, corn, fired foods, alcohol, spicy), avoid alcohol and caffeine, consume 2-3 L of fluid, increase fiber intake

gastritis

inflammation of stomach lining

gastritis causes

H. pylori, spicy or acidic foods, NSAIDs, acute stress, smoking, alcohol use

s/s of gastritis

loss of appetite, bloating, belching, N/V, abdominal pain

treatment of gastritis

avoid causes/risk factors, ABX for H. pylori, PPIs, H2 blockers, antacids