Upper GI Disorders - Nursing Clinical Concepts

Comprehensive vocabulary flashcards covering upper gastrointestinal tract anatomy, disorders, diagnostic tests, treatments, and nursing care.

Upper Gastrointestinal Tract

The anatomical portion of the digestive system comprising the oral cavity, esophagus, stomach, and duodenum up to the ligament of Treitz.

Lower Gastrointestinal Tract

The anatomical portion of the digestive system comprising the jejunum, ileum, colon, rectum, and anus.

Ligament of Treitz

The anatomical structure that defines the boundary between the upper gastrointestinal tract and the lower gastrointestinal tract.

Hematemesis

The vomiting of blood, which typically signifies a bleeding source in the upper gastrointestinal tract.

Hematochezia

The passage of fresh blood through the anus in stool, which typically signifies a bleeding source in the lower gastrointestinal tract.

Stomatitis

Inflammation of the oral mucosa that produces redness, painful ulcers, and difficulty with eating or swallowing.

Viscous Lidocaine

A topical local anesthetic solution, commonly referred to as Magic Mouthwash, utilized to alleviate severe pain from stomatitis.

Dysphagia

Difficulty swallowing food or liquid.

Odynophagia

Painful swallowing experienced during the passage of food or liquid.

Xerostomia

Dryness of the mouth resulting from reduced salivary flow, managed with hydration and avoidance of caffeine, alcohol, tobacco, and sugar.

Grade 1 Oral Stomatitis

A severity grade characterized clinically by redness of the mucosa, where the patient is able to eat a normal diet with minimal symptoms.

Grade 2 Oral Stomatitis

A severity grade characterized clinically by patchy oral ulcerations, where the patient is symptomatic but able to eat a modified diet.

Grade 3 Oral Stomatitis

A severity grade characterized clinically by confluent oral ulcerations that bleed with minor trauma, rendering the patient unable to eat or drink by mouth.

Grade 4 Oral Stomatitis

A severity grade characterized clinically by tissue necrosis with significant bleeding, presenting life-threatening functional consequences.

Grade 5 Oral Stomatitis

The most severe grade on the oral stomatitis scale, resulting in death.

Leukoplakia

Precancerous hyperkeratotic white patches on the oral mucosa that cannot be scraped off.

Erythroplakia

Precancerous red mucosal lesions in the oral cavity that carry a higher risk of malignant transformation than leukoplakia.

Non-Healing Oral Ulcer Biopsy Rule

A clinical rule stating that any oral sore or ulcer that fails to heal after $3\,weeks$ warrants a tissue biopsy to check for malignancy.

Esophageal Cancer Asymptomatic Threshold

The clinical principle that esophageal cancer often remains asymptomatic until the esophagus is more than $50\%$ obstructed.

Barrett's Esophagus

A complication of chronic GERD in which normal squamous epithelium of the lower esophagus undergoes metaplasia into columnar epithelium, increasing cancer risk.

Dumping Syndrome

A complication following gastric or bariatric surgery caused by rapid gastric emptying into the duodenum, leading to fluid shifts, hypotension, tachycardia, dizziness, and abdominal distress within $30\,minutes$ post-meal.

Hiatal Hernia

A condition in which a portion of the upper stomach pushes upward through the esophageal hiatus of the diaphragm into the thoracic cavity.

Type I Sliding Hiatal Hernia

The most common form of hiatal hernia, where the gastroesophageal junction and a small upper part of the stomach slide upward into the thorax.

Type II Paraesophageal (Rolling) Hiatal Hernia

A type of hiatal hernia where the gastroesophageal junction stays in place while a portion of the stomach rolls alongside the esophagus through the diaphragm, presenting risks of obstruction and volvulus.

N.A.P. Education Mnemonic

A patient teaching acronym standing for Nutrition (small meals, avoiding triggers), Avoidance (tight clothes, irritants, specific drugs), and Positioning (upright for $2\,hours$ post-meal, left-side sleeping with HOB at $30^\circ$).

Left Lateral Decubitus Positioning in GERD

The recommended sleeping orientation (lying on the left side with head of bed elevated at $30^\circ$) to reduce gastroesophageal acid reflux.

Nissen Fundoplication

A surgical procedure for severe GERD or hiatal hernia where the gastric fundus is wrapped around the distal esophagus to strengthen the lower esophageal sphincter.

Linx Device

A surgical implant containing a ring of magnetic beads placed around the lower esophageal sphincter to treat refractory GERD.

Gastropexy

A surgical intervention in which the stomach is attached or anchored to the abdominal wall to prevent displacement.

Gastroesophageal Reflux Disease (GERD)

A chronic disorder where stomach acid and gastric contents flow backward into the esophagus, producing esophageal inflammation and heartburn.

24-Hour Esophageal pH Monitoring

The diagnostic gold standard for evaluating GERD, measuring esophageal acid exposure over a full day.

Acute Gastritis

Transient inflammation of the gastric mucosa caused by physical stress, infection, NSAIDs, or alcohol, which typically resolves in $2\,days$.

Helicobacter pylori (H. pylori)

A flagellated bacterium that serves as the primary etiology for chronic gastritis and peptic ulcer disease by eroding protective mucus.

Autoimmune Gastritis

A form of chronic gastritis where the immune system attacks parietal cells and intrinsic factor, causing mucosal atrophy and pernicious anemia.

Sucralfate (Carafate)

A mucosal protective drug used in gastritis and ulcer care that binds to ulcer bases to form a protective barrier against acid and pepsin.

Peptic Ulcer Disease (PUD)

A condition characterized by mucosal erosions or ulcers in the lower esophagus, stomach, or duodenum secondary to acid and pepsin activity.

Gastric Ulcer

A peptic ulcer situated in the mucosal lining of the stomach wall, commonly linked to NSAID use or H. pylori infection.

Duodenal Ulcer

A peptic ulcer situated in the proximal small intestine, most frequently associated with H. pylori colonization.

Peritonitis Secondary to PUD Perforation

A life-threatening complication of a perforated peptic ulcer marked by a rigid, board-like abdomen, intense pain, tenderness, tachycardia, and hypotension.

EGD Gastric Antral Ulcer Report

An endoscopic finding showing a cratered ulcer in the gastric antrum with evidence of recent hemorrhage.

Gastric Lavage

The insertion of a nasogastric tube to flush and suction blood or contents out of the stomach during an upper GI bleed.

Gastric Cancer Risk Factors

Major risk conditions including H. pylori infection, Japanese/East Asian heritage, intake of smoked/BBQ foods, smoking, and chronic gastritis.

Early Satiety

The clinical symptom of feeling unusually full after eating a very small amount of food, often associated with gastric cancer or gastroparesis.

Billroth II (Gastrojejunostomy)

A partial gastrectomy in which the distal stomach is resected and the stomach remnant is connected directly to the jejunum.

Roux-en-Y Total Gastrectomy

Surgical removal of the entire stomach followed by an end-to-side anastomosis between the esophagus and a Y-loop of the jejunum.

Gastroparesis

A symptomatic condition of delayed gastric emptying in the absence of mechanical obstruction, resulting in slowed stomach motility.

Gastric Emptying Study

The definitive diagnostic test used to measure the rate at which food empties from the stomach to confirm gastroparesis.

GLP-1 Receptor Agonists and Gastroparesis

A class of antidiabetic/weight-loss medications that delay gastric emptying and can exacerbate underlying gastroparesis.

Gastroparesis Dietary Management

Nutritional management consisting of 4-6 small frequent meals per day that are low in fat and low in fiber, utilizing soft or liquid foods.

Bariatrics

The clinical medical specialty focused on the etiology, prevention, and treatment of obesity and its related health conditions.

Underweight BMI Category

An NIH body mass index classification defined as less than $18.5\,kg/m^2$.

Normal Weight BMI Category

An NIH body mass index classification defined as $18.5-24.9\,kg/m^2$.

Overweight BMI Category

An NIH body mass index classification defined as $25.0-29.9\,kg/m^2$.

Obesity BMI Categories

NIH obesity classifications comprising Class 1 ($30.0-34.9\,kg/m^2$), Class 2 ($35.0-39.9\,kg/m^2$), and Class 3 Extreme Obesity ($>40.0\,kg/m^2$).

Bariatric Weight Loss Caloric Deficit Rule

The rule stating a $500\,kcal$ daily deficit yields $1\,lb$ ($0.45\,kg$) of weekly weight loss, while diets below $800\,kcal$ daily mandate medical supervision.