Gastrointestinal System Flashcards
What are some contributing factors to gastrointestinal tract conditions?
Bleeding, trauma, perforation, obstruction
Inflammation, infections, infestations
Tumours; benign and malignant
Congenital disorders
Circulatory and nervous system faults
Ageing
High levels of stress and anxiety
Irregular eating habits
Low fibre and water intake
Low levels daily exercise
Congenital /genetic influences
What are the signs and symptoms of Gastrointestinal disease?
Change in appetite
*Weight gain or loss
*Dysphagia
*Intolerance to certain foods
*Nausea and vomiting
Change in bowel habits
Abdominal pain
Flatus
These are sometimes ignored, not recognised by patients or treated by over the counter (OTC) medications
What is Cholecystitis?
Gall bladder inflammation
Associated with:
A mixture of particulate solids precipitated from bile. Consists of cholesterol crystals, calcium bilirubinate pigment, and other calcium salts.
Gallstones (may be asymptomatic)
Incidence higher in females >40yrs
Acute cholecystitis:
Pain + rigidity of upper abdomen
pain radiates to mid sternum or right shoulder region
Associated with nausea and vomiting.
If the common bile duct becomes obstructed = jaundice (yellow tinge to the skin associated with itchiness)
What are the causes of Constipation?
Colonic disorders e.g. volvulus, irritable bowel syndrome (IBS), diverticular disease
Drug induced e.g. antacids, barium sulphate, laxative abuse, opioids, antidepressants.
Opioid induced constipation is a significant issue for post surgical patients.
Management includes regular aperients(prescribed) avoiding use of other constipating medications. Mobilisation and fluids.(Brown, Edwards, Seaton & Buckley,2015 pg. 65)
Systemic disorders e.g. diabetes, spinal cord lesions, stroke
Pregnancy
What is Appendicitis?
Results from kinking or occlusion by faecalith.(hardened mass of faecal matter)
Pain periumbilical progressing to RT lower quadrant at McBurney’s point
Rebound tenderness on palpation
Low grade fever/nausea vomiting
Complications
Peritonitis or localised abscess can occur within 24 hours after onset of pain
What is Irritable Bowel Syndrome?
Results from functional disorder of intestinal motility
Symptoms are present for at least 3 days a month
Chronic intermittent & recurrent abdominal pain
Irregular bowel habit
Diarrhoea, constipation, abdominal distension, flatulence, bloating
Continual defecation urge, urgency, feeling of incomplete evacuation
What is Crohns Disease?
Crohn’s disease:
Common in young adults and adolescents. More common in women and older population (50-80 years).(Farrell,M (2017 p 1011)
Subacute ,chronic inflammation of all layers of colon(transmural)
Oedema and thickening progressing to ulceration of mucosa
Skip lesions separated by normal tissue
Scar tissue and formation of granulomas interfere with normal colon function
What is Ulcerative Colitis?
More common in Caucasian and people of Jewish descent. Peak incidence between 30-50 years 5% patients may go on to develop colon cancer. (Farrell,M ,2017, p 1013)
Affects superficial mucosa rectum and colon
Multiple ulcerations, desquamation of epithelium,
Abscesses form infiltrating submucosa layers
Bowel narrows, shortens presence of fistulas
What are the signs and symptoms of inflammatory bowel disease?
Common for both conditions:
Abdominal pain – usually mild – moderate (Crohn’s) onset in right lower quadrant
Diarrhoea
Bloody stools (more likely with UC)
Weight loss (Crohn’s)
Fever (UC during acute attacks. Common with Chron’s)
Fatigue
Malabsorption
What are the two inflammatory bowel diseases?
Crohn’s disease and Ulcerative colitis
What is the treatment for inflammatory bowel diseases?
Rest the bowel, control inflammation, combat infection, correct malnutrition, alleviate stress, symptomatic relief
Medications
Surgery – 75% of Crohns require surgical intervention either stricturoplasty or resection +/- temp ostomy or ileostomy
Nutritional therapy - according to triggers, malnutrition etc +/- TPN
Some people with IBD suffer extra-intestinal manifestations of disease including arthritis, ankylosing spondylitis, eye inflammation and skin lesions thought to be cause by circulation products of inflammation triggering inflammation in other areas.
What is Volvulus?
Latin word - rolled up, twisted
Twisting of part of intestine around itself = obstruction
Frequently in colon, but can occur in stomach and small bowel
Can lead to: gangrene, obstruction, perforation, peritonitis & death
What are risk factors for colorectal cancer?
Gender ↑males
Age > 55
Family history, familial adenomatous polyposis (FAP)
Colorectal polyps
Inflammatory bowel disease (IBD)
Obesity
Smoking
Excess alcohol consumption
High fat diet
Low fibre diet
What are the tests leading up to a disgnosis of CA Bowel (cancer)
Biopsy from colonoscopy – histology report and mass visualised
CEA( carcinoembryonic antigen) elevated readings.
Abnormal blood results
Mass visualised on CT scan
Palpable mass felt during abdominal examination.
AFTER DIAGNOSIS
Staging /classification of colorectal cancer dictates the management.
Surgery required to remove tumour and part of bowel e.g. hemicolectomy. Abdominal-perineal resection. Laparoscopic colectomy.
May require chemotherapy , radiotherapy, biological and targeted therapy.
What is Colorectal Surgery - Colectomy?
Partial removal of the colon or removal of the entire colon is one of the most common forms of colorectal surgery
The name of the procedure describes the extent of the surgery e.g. hemicolectomy - part of the ascending or descending colon
