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.