Upper GI Disorders Flashcards

1
Q

Upper GI

A

Esophagus
Stomach
Beginning of small Intestines

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2
Q

Lower GI

A

Small intestines
Colon
Large Intestines
Rectum/Anus

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3
Q

Dysphagia Definition

A

Difficulty swallowing

-Begins with solids and progresses to liquids

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4
Q

Common Causes of Dysphagia

A
  1. Mechanical obstruction
    - Stenosis
    - Diverticula
    - Tumors
  2. Neuromuscular dysfunction
    - CVA (stroke)
    - Achalasia (LES can’t open properly)
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5
Q

LES

A

Lower Esophageal Sphincter

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6
Q

GERD is a problem with the…

A

Lower Esophageal Sphincter (LES)

-

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7
Q

GERD Etiology

A

Anything that alters closure strength of LES or increases abdominal pressure

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8
Q

GERD Foods + Irritating Factors

A
Fatty foods
Spicy foods
Tomato based
Citrus
Caffeine
Excess alcohol
Cigarettes
Sleep Position
Obesity
Pregnancy
Certain drugs
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9
Q

GERD: Manifestations

A
Pyrosis (heartburn)
Dyspepsia (indigestion or pain in stomach)
Regurgitation
Chest pain
Dysphagia
Pulmonary symptoms
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10
Q

Other GERD Manifestations

A

Mouth

  • tooth decay
  • gingivitis
  • bad breath

Chest

  • Chronic cough
  • Worsening asthma
  • Recurrent PNA

Abdomen

  • Bloating
  • Belching

Ears
-Earache

Throat

  • Hoarseness
  • chronic sore throat
  • Throat clearing
  • Laryngitis
  • Lump in throat
  • Post nasal drip
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11
Q

GERD Complications

A

Ulcerations
Scarring
Strictures
Barret’s esophagus

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12
Q

Barrett’s

A

Development of abnormal Metaplastic tissue

  • 3x risk for adenocarcinoma
  • Overall survival only 17%
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13
Q

Upper GI: Hiatal Hernia

A

Defect in diaphragm that allows part of the STOMACH to pass into the THORAX

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14
Q

2 types of Hiatal Hernia

A
  1. Sliding Hernia- usually small and often no treatment needed
  2. Paraoesophageal- part of stomach pushes through the diaphragm and stays there
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15
Q

Hiatal Hernia: Patho (Causes)

A

-Exact Cause unknown
-Age related
-Obesity
-Injury or other damage may weaken the diaphragm
-Repeatedly putting to much pressure on the muscles around the stomach
+Severe coughing
+Vomiting
+Constipation and straining

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16
Q

HH: Symptoms

A
  1. Asymptomatic
  2. Belching
  3. Dysphagia
  4. Chest or epigastric pain
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17
Q

HH Risk Factors

A

Age
Obesity
Smoking

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18
Q

HH treatment

A

MOSTLY CONSERVATIVE

  • small, freq meals, avoid laying after meal
  • avoid tight clothing and abd supports
  • Weight control for obesity
  • Antacids for GERD
  • Surgery if Bad
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19
Q

Inflammatory disorders of the stomach

A

Gastritis
Acute Gastroenteritis
PUD

20
Q

Acute Gastritis

A

TEMPORARY inflammation of stomach lining (Intestines NOT affected)

21
Q

Acute Gastritis Etiology

A

Lasts 2-10 days

  1. Irritating substances (alcohol)
  2. Drugs (NSAIDS)
  3. Infectious Agents
    - H. pylori most common
22
Q

Chronic Gastritis (2 main etiologies)

A

Progressive disorder with chronic inflammation in the stomach

2 Main etiologies

  1. Autoimmune
    - attacks parietal cells
  2. chronic H. Pylori infection
23
Q

How long does chronic gastritis last?

A

Weeks to years

24
Q

Chronic Gastritis Complications

A
PUD
Bleeding
Ulcers
Anemia
Gastric Cancers
25
H. pylori
Helicobacter pylori (gram -, spiral) -acidic environment -Destructive pattern of persistent inflammation
26
How is H. pylori transmitted?
1. person to person via saliva, fecal matter, or vomit | 2. Contaminated food or water
27
Acute + Chronic Gastritis Symptoms
``` None Anorexia N/V (w/ or w/o blood) Postprandial discomfort (after meals) Intestinal gas Hematemesis (vomiting blood) Tarry or black stools Anemia ```
28
Acute Gastroenteritis
Inflammation of stomach AND intestine
29
Acute Gastroenteritis: Etiology
Viral Infections: norovirus + rotavirus Bacterial Infections: E. Coli, salmonella, campylobacter Parasitic infections
30
Acute Gastroenteritis: How long does it last?
Usually 1-3 days but may last as long as 10 days
31
Acute Gastroenteritis: Symptoms
``` Watery Diarrhea -bloody if bacterial Abdominal Pain N/V Fever, malaise ```
32
Acute Gastroenteritis: Major complication
Fluid volume deficits
33
Peptic Ulcer Disease
Ulcerative disorder of upper GI tract - Esophageal - Stomach (gastric ulcers) - Duodenum (peptic ulcer in first part of small intestine)
34
PUD is from?
when GI tract is exposed to acid + H. pylori
35
GI health Balancing Act: Aggressive Factors
``` H. pylori NSAIDS Acid Pepsin Smoking ```
36
GI health Balancing Act: Defensive Factors
Mucus Bicarbonate Blood flow Prostaglandins
37
PUD: Etiology (What factors cause it?)
1. H. pylori 2. Injury Causing Substances - NSAIDS, ASA, Alcohol 3. Excessive secretion of acid 4. Smoking 5. Family Hx 6. Stress (increases acid secretion)
38
PUD: Risk Factors
- Age - Higher doses of NSAIDs - Hx of PUD - Corticosteroids + Anti coags - Serious systemic disorders (autoimmune) - H. Pylori infection
39
PUD pathogenesis
Mucosa is damaged Histamine is secreted: -Inc Acid + Pepsin secretion causes further tissue damage -Vasodilation (edema) If blood vessels are destroyed, this results in BLEEDING
40
PUD Classification: Duodenal Ulcer
- Most common | - Any age, early adulthood
41
PUD Classification: Gastric/Peptic Ulcer | -What age and why this age?
Age: 50-70 WHY This Age? -Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious system illnesses
42
PUD Clinical Manifestations
``` Sometimes none N/V, Anorexia Weight loss Bleeding Burning pain (in middle of abdomen that is usually worse when stomach is EMPTY) ```
43
PUD: Gastric Ulcer Pain
Characteristics: Burning, cramping, gas-like Location: Epigastrium, back Timing: 1-2 hours after eating
44
PUD: Duodenal Pain
Characteristics: Burning, cramping, gas-like Location: Epigastrium, back Timing: 2-4 hours after eating
45
PUD Complications
"HOP" Hemorrhage Obstruction Perforation + Peritonitis