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.