Session 18: Upper and Lower GI Disorders Vocabulary

Gastritis

  • Definition: Inflammation of the protective mucosal lining of the stomach.

  • Pathophysiology: A compromised mucous barrier allows acidic digestive juices to erode and inflame the stomach wall.

  • Key Symptoms: Epigastric burning/gnawing pain, nausea, vomiting, and fullness after eating; can also present asymptomatically.

  • Etiology & Risk Factors: Helicobacter pylori infection, regular NSAID use (e.g., ibuprofen, naproxen), excessive alcohol, severe physical stress, advanced age, autoimmune responses, and oncological therapies.

  • Complications: Peptic ulcers, GI bleeding, and gastric carcinoma (with chronic mucosal thinning).

  • Diagnosis: H. pylori testing (stool antigen/urea breath test), upper endoscopy with biopsy, and barium swallow X-ray.

  • Treatment & Prevention: Antibiotics for H. pylori, PPIs, H2 blockers, antacids, alcohol avoidance, and substituting NSAIDs with acetaminophen.

Gastroesophageal Reflux Disease (GERD)

  • Definition & Pathology: Chronic condition caused by frequent backflow of acidic or nonacidic gastric contents into the esophagus due to Lower Esophageal Sphincter (LES) dysfunction.

  • Key Symptoms: Retrosternal heartburn (worse flat or at night), regurgitation, chest/epigastric pain, dysphagia, and globus sensation.

  • Risk Factors: Obesity, hiatal hernia, pregnancy, scleroderma, and gastroparesis.

  • Complications: Esophagitis, esophageal strictures, and Barrett's esophagus (precancerous metaplasia).

  • Diagnosis: Upper endoscopy, ambulatory pH monitoring, barium swallow series, esophageal manometry, and transnasal esophagoscopy.

  • Treatment: Antacids, H2 blockers, PPIs, and surgical interventions (Fundoplication, LINX device, and TIF).

Peptic Ulcer Disease

  • Definition & Types: Open mucosal sores in the upper GI tract, classified as Gastric Ulcers (stomach) or Duodenal Ulcers (duodenum).

  • Key Symptoms: Burning epigastric pain, bloating, belching, fatty food intolerance, and nausea.

  • Etiology: Primary causes are H. pylori infection and regular NSAID use (risk compounded when combined with steroids, anticoagulants, SSRIs, or bisphosphonates).

  • Complications: Internal hemorrhage (hematemesis, melena), perforation leading to peritonitis, luminal obstruction, and gastric adenocarcinoma.

  • Prevention: Maintaining proper hygiene to prevent H. pylori and restricting long-term NSAID usage with gastroprotective co-therapies.

Irritable Bowel Syndrome (IBS)

  • Definition: Functional lower GI disorder characterized by recurrent abdominal pain and altered bowel habits without structural tissue damage.

  • Key Symptoms: Cramping, abdominal pain, bloating, and fluctuating bowel habits (IBS-D, IBS-C, or mixed patterns).

  • Etiology & Triggers: Intestinal muscle motility dysfunction, gut-brain axis hypersensitivity, post-infectious onset (e.g., dysentery, cholera), dysbiosis, stress, and food intolerances.

  • Risk Factors: Age under 50, female sex (and estrogen therapy), family history, and psychological stress or abuse history.

  • Complications: Hemorrhoids, reduced quality of life, and associated psychological distress (anxiety/depression).