GI Disorders Notes

GI Bleeding

• Definition: Loss of blood from the gastrointestinal tract which may lead to serious conditions.
• Symptoms:
  • Vomiting of blood or material resembling coffee grounds.
  • Melena (black, tarry stools) and hematochezia (bright red blood in stools).
• Common Causes:
  • Peptic ulcers:
  • Erosion of stomach lining due to high acidity.
  • Diverticular disease: Pouches formed in the colon that can become inflamed.
  • Cancer: Possible bleeding or obstruction.
  • Inflammatory bowel diseases: Crohn’s disease and ulcerative colitis can lead to bleeding.
  • Trauma: May cause internal bleeding leading to hemorrhage.

Alterations in Bowel Habits

• Causes:
  • Contaminated food, bacteria, viruses, fungi bypassing immune system.
  • Around one-sixth of the Canadian population experiences bowel disturbances annually.
• Conditions:
  • Constipation: Reduced bowel speed often leading to discomfort.
  • Bowel obstruction: Blockage preventing normal movement of waste.

Specific Conditions of Gastrointestinal Diseases

• Acute Abdomen:
  • Can stem from appendicitis, cholecystitis, aortic aneurysm.
  • Symptoms include pain, hemorrhage, sepsis.
• Appendicitis:
  • Caused by obstruction leading to accumulation and possible rupture.
  • Symptoms include abdominal pain, fever, nausea, vomiting.
• Cholecystitis:
  • Caused by gallstone obstruction leading to inflammation of the gallbladder.
  • Symptoms: severe pain, fever, jaundice.

Peptic Ulcer Disease

• Definition: Sores on the lining of stomach or duodenum due to high acidity.
• Causes:
  • Majorly resulting from Helicobacter pylori infection, chronic NSAID use, excessive alcohol, smoking.
• Symptoms:
  • Pain, hemorrhage.

Pancreatitis

• Definition: Inflammation of the pancreas, where enzymes are prematurely activated.
• Risk Factors: Alcohol, gallstones, drug reactions, trauma, high triglycerides.
• Symptoms:
  • Severe abdominal pain, hemorrhaging, potential sepsis.

Esophageal Varices

• Definition: Dilated veins in the esophagus due to liver damage.
• Causes: Cirrhosis from alcohol or viral hepatitis.
• Symptoms:
  • Upper GI bleeding, risk of rupture leading to hemorrhage.

Mallory-Weiss Syndrome

• Definition: Tears in esophageal lining from severe vomiting.
• Risks: May lead to severe hemorrhage, pneumothorax.

Diverticulitis

• Definition: Inflammation of diverticula in the colon due to trapped feces.
• Symptoms: Abdominal pain, possible bleeding, changes in bowel habits.

Ulcerative Colitis & Crohn’s Disease

• Ulcerative Colitis:

  • Chronic inflammatory condition affecting colon, with risk factors including age, and hereditary component.

• Crohn’s Disease:

  • Similar to ulcerative colitis but can affect any GI tract part.
  • Symptoms include abdominal pain and weight loss.

Initial Assessment

• Factors:
  • Assess airway, breathing, circulation, identify signs of shock.
  • Monitor vital signs including heart rate, blood pressure, and temperature.
• Focused History:
  • Obtain history of present illness, medications, and family history.

General Management Guidelines

• Goals: Manage ABCs (Airway, Breathing, Circulation), pain, and hydration.
• Fluid Management: Administer IV fluids for dehydration and hypotension.
• Monitoring: Ongoing assessments for vital signs and response to treatment.

Vocabulary**

• Melena: Black, tarry stools indicating upper GI bleeding.
• Hematochezia: Bright red blood in stool indicating lower GI bleeding.
• Ascites: Accumulation of fluid in the abdominal cavity.
• Hematemesis: Vomiting blood.
• Orthostatic Vitals: Measurements taken to assess blood pressure and heart rate upon changing positions for signs of dehydration or blood loss.