med surg GI 3/13/25

Gastroesophageal Reflux Disease (GERD)

  • Symptoms and Signs:

    • Common symptoms include:

      • Diarrhea

      • Dyspepsia

      • Indigestion.

    • It's crucial to understand GERD as it relates to exam preparation.

Peptic Ulcer Disease (PUD)

  • Definition:

    • A peptic ulcer is an open sore in the stomach lining or duodenum caused by acid.

    • Types of Ulcers:

      • Gastric Ulcer: Found in the stomach.

      • Duodenal Ulcer: Located at the beginning of the small intestine (duodenum).

    • Patients may have both types simultaneously.

Signs and Symptoms of Peptic Ulcers

  • Symptoms can vary, and some may show no symptoms at all.

  • Common signs include:

    • Abdominal pain (can be influenced by food consumption):

      • Gastric: Pain may worsen with food.

      • Duodenal: Pain may decrease with food.

    • Other symptoms:

      • Nausea

      • Vomiting

      • Feelings of bloating

      • Complications may lead to:

        • Anemia symptoms such as fatigue and shortness of breath.

      • Bleeding Symptoms:

        • Melena (black, sticky stool)

        • Hematemesis (vomiting red blood or coffee-ground-like material).

Helicobacter Pylori (H. Pylori)

  • Overview:

    • Bacterium residing in the stomach, implicated in ulcer formation.

    • Significant medical discovery; Nobel Prize awarded in 2005 for its role in causing ulcers.

  • Treatment:

    • Combination of acid suppression therapy (Proton Pump Inhibitors - PPIs)

    • Antibiotics

    • Agents like Pepto Bismol can assist.

NSAID Use and Ulcers

  • NSAIDs are common pain relievers but can lead to peptic ulcers by:

    • Disrupting the stomach's ability to protect against acid.

  • Preferred Alternative:

    • Acetaminophen (Tylenol) is safe for those at risk for ulcers.

Hepatitis Overview

  • Definition and Types:

    • Hepatitis is inflammation of the liver, influenced by various factors including infections and toxic agents.

    • Major types: Hepatitis A, B, C (most relevant in the U.S.)

      • Transmission:

        • Hepatitis A & E: Fecal-oral route (contaminated food/water).

        • Hepatitis B & C: Blood-borne (IV drug use, sexual contact).

Symptoms of Hepatitis

  • Acute Viral Hepatitis:

    • Symptoms include:

      • Low-grade fever

      • Muscle aches

      • Nausea and vomiting

      • Dark urine or light-colored stool

      • Jaundice (yellowing of skin and eyes).

    • Acute is defined as less than six months; chronic is more than six months.

Cirrhosis

  • Definition:

    • Progressive liver damage leading to loss of function.

    • Major causes include excessive alcohol use, chronic infections, viral hepatitis.

  • Symptoms:

    • Fatigue

    • Itching

    • Edema (fluid retention, often in the legs)

    • Ascites (fluid buildup in the abdominal cavity)

    • Jaundice.

Complications of Cirrhosis

  • Increased risk of:

    • Digestive tract bleeding (varices)

    • Hepatic encephalopathy (confusion, drowsiness, slurred speech).

  • Diagnosis often involves liver biopsy, which is a high-risk procedure.

  • Treatment Strategies:

    • Treat underlying causes, manage complications, and abstain from alcohol.

    • Circle back to the importance of managing symptoms (e.g., lactulose for hepatic encephalopathy).

Zollinger-Ellison Syndrome & Other Considerations

  • This syndrome involves gastrin-secreting tumors leading to increased gastric acid production.

  • General Advice:

    • When presenting with symptoms, consider travel history, as many diseases present differently in places with less sanitation. 👶

    • Be mindful of educational resources provided on these health issues for ensuring thorough preparation for the exam.