Gastrointestinal and Digestive System Disorders: Comprehensive Review

Celiac Disease

• Autoimmune disorder triggered by gluten (protein in wheat, barley, and rye).
• Damages the small intestine.
• Immune system attacks the small intestine when gluten is ingested, leading to inflammation and damage.
• Prevents nutrient absorption, causing malabsorption and other health problems. *Symptoms Vary:
  • Affects digestion, skin, and nervous system.
  • In children: frequent diarrhea, failure to thrive, developmental delays.
  • In adults: fatigue, weight loss, abdominal pain.
  • Dermatitis herpetiformis (skin rash).
• Interesting Fact:
  • People with Celiac disease may have lactose and fructose intolerance, diagnosed by a hydrogen breath test.

Crohn's Disease

• Inflammatory bowel disease (IBD) causing swelling and irritation of the digestive tract tissues, usually due to abnormal immune system reactions.
• Commonly affects the end of the small intestine and the beginning of the large intestine but can affect any part of the digestive system.
• Symptoms:
  • Diarrhea, fever, fatigue, belly pain, stomach cramps, bloody stool, mouth sores, reduced appetite, weight loss.
  • Pain or drainage near the anus due to a fistula.
  • Inflammation of skin, eyes, joints, bile ducts, or liver.
  • Anemia and renal calculus.
• Facts:
  • Commonly develops around age 30.
  • Cigarette smoking increases risk.
  • NSAIDs can worsen Crohn's disease.
  • Chronic, no cure.
  • Higher possibility among those of Jewish descent.
  • Increased risk of cancer.
  • Reducing stress and good sleeping habits can reduce flares.
  • Crohn's disease is different for everyone.

GERD (Gastroesophageal Reflux Disease)

• Stomach acid flows back into the esophagus, irritating its lining (acid reflux).
• Most people manage with medication and rest.
• Symptoms:
  • Heartburn.
  • Upper belly or chest pain.
  • Dysphagia (difficulty swallowing).
  • Nighttime acid reflux.
  • Ongoing cough and laryngitis (inflammation of vocal cords).
• Causes:
  • Frequent acid reflux, backwash of food.
• Risk Factors:
  • Obesity, bulging of the top of the stomach, pregnancy, delayed stomach emptying, connective tissue disorders (e.g., scleroderma).
• Aggravating Factors:
  • Smoking, large or late meals, oily/fatty foods, alcohol, medications like aspirin.
• Complications:
  • Inflammation or narrowing of the esophagus.

Diverticulosis/Diverticulitis

• Diverticulosis: Small pouches (diverticula) form on the inside lining of the large intestine due to food/waste pushing against weak spots.
• Diverticulitis: One or more pouches become inflamed.
• Symptoms of Diverticulitis: Lower abdominal pain or fever.
• Prevention: Incorporate more fiber into the diet to prevent constipation and bloating, making stool softer and easier to pass.

Anal Fissure

• Description: Small tear in the lining of the anus, causing bleeding during bowel movements and pain.
• Symptoms:
  • Pain during bowel movements.
  • A crack in the skin around the anus.
  • Blood on stool.
  • Pain to lower back and constipation.
• Treatment:
  • Stool softeners to reduce pain during bowel movements.
  • Adjust diet: increase water intake, avoid spicy foods.
  • Surgery if other treatments fail.
• Chronic Fissure:
  • If not healed within 8 weeks, considered chronic, may require serious treatment.
  • Prone to recurrence.
  • Unhealed fissures may require surgery due to discomfort.

Colorectal Cancer

• Starts as benign polyps on the inner lining of the colon or rectum; removal can prevent cancer growth.
• Located in the lower end of the digestive tract.
• Originates in the innermost layer and grows outward through the colon and rectum walls.
• Most are adenocarcinomas, starting in glands lining the organs.
• Symptoms:
  • Changes in bowel habits.
  • Rectal bleeding or blood in the stool.
  • Abdominal pain or cramping.
  • Unexplained weight loss or fatigue.
• Diagnosis & Treatment:
  • Colonoscopies and other screening tests detect polyps/early-stage cancer.
  • Surgery, chemotherapy, radiation therapy.
• Stages:
  • Describe how much cancer is in the body; determine seriousness and treatment.
  • Stage 0: earliest stage.
  • Stages range from 1 to 4.

Gastroenteritis

• Overview:
  • Known as the stomach flu.
  • Inflammation of the mucous membrane lining the stomach and intestinal tract.
• Causes:
  • Food poisoning, infection, toxins.
• Symptoms:
  • Abdominal cramping, nausea, vomiting, fever, diarrhea.
• Treatment:
  • Rest and fluids in most cases.
  • Severe cases: antibiotics, intravenous fluids, antiemetics (for vomiting), medicine to slow peristalsis.
  • Probiotics may be helpful.

Hernia

• Occurs when an internal organ pushes through a weakened area or natural opening in a body wall.
• Types and Locations:
  • Inguinal: bowel protrudes into the inguinal canal (most common, usually affects men).
  • Femoral: bowel protrudes into the femoral canal.
  • Hiatal: stomach protrudes through the diaphragm.
  • Congenital Diaphragmatic: diaphragm does not close during fetal development (birth defect).
  • Incisional: tissue protrudes at a former incision (common after abdominal surgery).
  • Umbilical: intestine protrudes through an opening near the umbilical area (congenital).
  • Ventral: any hernia located on the front wall of the abdomen.
  • Perineal: organ/tissue protrudes through an opening in the pelvic floor.

H. Pylori Infection

• Caused by Helicobacter pylori, a spiral-shaped bacterium infecting the stomach lining.
• Common infection, affecting approximately half the world's population.
• Many people are asymptomatic.
• Can cause chronic gastritis (inflammation of the stomach lining).
• Major cause of peptic ulcers (sores in the stomach or duodenum).
• Symptoms: abdominal pain, nausea, loss of appetite, bloating.
• Diagnosis: breath tests, stool tests, or endoscopy with biopsy.
• Treatment: antibiotics to kill bacteria, acid-reducing medications to heal the stomach lining.

Pancreatitis

• Inflammation of the pancreas.
• Acute Pancreatitis:
  • Sudden, short-term.
  • Symptoms: Severe abdominal pain radiating to the back, tenderness of the abdomen, nausea, vomiting.
  • Treatment: Hospital stay with IV fluids, pain medication, antibiotics.
• Chronic Pancreatitis:
  • Ongoing, long-term.
  • Causes permanent damage to the pancreas; can cause it to stop producing enzymes and insulin.
  • Symptoms: Recurring abdominal pain, weight loss, diabetes, rapid heart rate, swelling in the upper belly, fever, jaundice.
  • Causes: Excessive alcohol consumption, gallstones.
  • Treatment: Low-fat diet, surgery, vitamins.

Peptic Ulcer Disease

• Description: Open sores in the lining of the stomach or duodenum (the first part of the small intestine).
• Symptoms:
  • Dull or burning stomach pain (may be worse between meals, at night, or after eating).
  • Feeling of fullness or bloating.
  • Heartburn, nausea.
• Treatment:
  • Antibiotics to kill H. pylori.
  • Medicines to block or reduce stomach acid.
  • Antacids to counter stomach acid effects.
  • Medicines to protect the lining of the stomach and small intestine.
• Causes:
  • Helicobacter pylori (H. pylori), frequent use of NSAIDs, excess stomach acid, smoking, alcohol, stress.
• Risk Factors:
  • Infection with H. pylori, frequent use of NSAIDs, smoking, excessive alcohol, stress, family history, age, other medical conditions, unhealthy diet, irregular eating habits.

Steatorrhea

• Excessive amounts of fat in stool.
• Causes:
  • Digestive system trouble breaking down and absorbing fats.
  • Exocrine pancreatic insufficiency (pancreas unable to produce enough pancreatic enzymes).
  • Liver diseases and bile duct issues.
  • Conditions interfering with the small intestine's ability to break down fats.
• Symptoms:
  • Loose stool, foul smell, pale color, floating, abdominal pain, dehydration, oily texture, weight loss.
• Treatment:
  • Mild: limit high-fat/fiber foods, maintain a healthy diet.
  • Severe: Pancreatic enzyme replacement therapy (PERT), gluten-free diet, antibiotics.

Hemorrhoids

• Swollen and inflamed veins in the lower rectum and anus.
• Internal Hemorrhoids:
  • Location: Inside rectum (painless area).
  • Symptoms: Bright red bleeding, prolapse (may stick out), discomfort.
  • Causes: Straining, constipation, low fiber, sitting too long, pregnancy.
  • Treatment: Fiber, fluids, stool softeners, sitz baths, creams/suppositories, rubber band ligation, surgery (if severe).
• External Hemorrhoids:
  • Location: Under skin around the anus (pain-sensitive).
  • Symptoms: Pain, swelling, lump near anus, itching, sometimes bleeding.
  • Causes: Same as internal.
  • Treatment: Sitz baths, ice packs, pain relievers, topical creams, minor surgery if thrombosed (painful clot).

Gallstones (Cholelithiasis)

• Formation and hardening of bile salts and pigments due to cholecystitis (inflammation of the gallbladder).
• Symptoms: Indigestion, nausea and vomiting (emesis), fever (pyrexia).
• Treatment: Low-fat diet, analgesics (pain medications), lithotripsy (shock waves to shatter stones), cholecystectomy (surgical removal of gallbladder).
• Laparoscopic surgery: minimally invasive surgery using lasers (less painful, smaller incisions, reduces infection risk).
• Gallbladder rupture is rare but life-threatening.
• Untreated gallstones can lead to complications; treatment depends on surgery type needed.

Ulcerative Colitis

• Inflammatory bowel disease (IBD) causing ulcers and inflammation in the lining of the rectum and colon.
• Causes: No definitive causes, but factors include genes, abnormal immune reactions, microbes in the digestive tract, environment.
• Symptoms:
  • Common symptoms: Diarrhea, blood in stool or rectal bleeding, abdominal pain and cramping, mucus or pus in stool, constant urge to defecate (tenesmus).
  • Severe symptoms: Fatigue, fever, nausea or vomiting, weight loss.
• Remission and Relapse: Symptoms may have periods of remission (weeks to years), followed by relapse.
• Diagnosis:
  • Family history, physical exam, blood test, stool test, endoscopy of the large intestine.
• Treatment:
  • Medications to reduce inflammation (aminosalicylates, corticosteroids, biologics), ileoanal reservoir surgery, ileostomy.

Intussusception

• Medical emergency: one segment of intestine folds inside another (telescoping).
• Most common in children between 3 months and 3 years old.
• Symptoms: Abdominal pain, N/V, red jelly-like stool, swollen belly, lethargy.
• Diagnosis: Ultrasound, CT Scan.
• Treatment: Enema (also used for diagnosis), surgery (open or laparoscopy).

Irritable Bowel Syndrome (IBS)

• Description: Common condition affecting the gastrointestinal tract, especially the stomach and intestines.
• Symptoms:
  • Changes in stool frequency, cramping/bloating, constipation, changes in stool appearance.
• Causes: Exact cause unknown; factors include muscle contractions in the intestines, early life stress, the nervous system, bacteria/virus; symptoms triggered/worsened by food, stress, menstrual cycle.
• Risk Factors: Young age (under 50), female gender, family history of IBS, anxiety, depression, or other mental issues.
• Types of IBS:
  • IBS-C (with constipation): hard and lumpy stool.
  • IBS-D (with diarrhea): watery and loose stool.
  • IBS-M (mixed): hard, lumpy, watery, and loose stool.
• Treatment/Lifestyle Changes: Limit dairy, add fiber, limit gassy foods, avoid gluten, drink lots of water, get enough sleep, exercise daily.