Pathology Notes – Digestive System

Diseases and Conditions of the Oral Cavity

I. Introduction
A. The function of the teeth is to break down the food into smaller pieces that can be
swallowed and digested easily
B. Infection of teeth and gums, malocclusion, or missing teeth can hinder this process
C. Most diseases involving the mouth or tongue are not serious and easy to treat
D. Malignant tumors are possible.
Missing Teeth
I. Symptoms and Signs
A. Can change the bite and lead to TMJ
B. Can be due to decay or accident
C. To treat replace with false teeth
D. To prevent practice good oral hygiene
II. Etiology
A. The most common cause is loss from decay or accident
Impacted Molars
I. Description
A. Is a malpositioned third molar
II. Symptoms and Signs
A. Also known as wisdom teeth
III. Are impacted because they don’t have enough room to grow because of bone structure or because
adjacent teeth block eruption
Dental Caries
I. Description
A. Is considered and infection resulting in erosion of the tooth surface
II. Etiology
A. Occur when bacteria in plaque break down the sugar in food
B. This process forms acid
1. Erodes calcium in tooth enamel and causes a cavity to form
Discolored Teeth Teeth can be slight yellow to brown
I. Teeth can be slight yellow to brown
II. Age causes yellowing as so does smoking and coffee drinking
III. Dead teeth are gray
IV. Disease and some drugs can also cause discoloration

Gingivitis
I. Description
A. Is an inflammation and swelling of the gums
II. Symptoms and Signs
A. Gums become red, soft, and shiny
B. Gums bleed easily
C. If not treated leads to destruction of gums and bone disease(periodontitis
III. Etiology
A. The most common cause is plaque
Periodontitis
I. Symptoms and Signs
A. Is the end result of gingivitis
B. Gum and bone are destroyed
Temporomandibular Joint Syndrome(TMJ)
I. Description
A. Inflammation, disease, or dysfunction of the temporo-mandibular joint
II. Symptoms and Signs
A. Limited jaw movement, clicking sounds during chewing or pain made worse by
chewing
III. Etiology
 A. Can be caused by poorly fitting dentures, arthritis, and stress, clenching or
grinding of teeth
Mouth Ulcers
I. Description
A. Is a lesion on the mucous membrane, exposing underlying sensitive tissue
II. Symptoms and signs
A. Also called a canker sore
B. Can be caused by stress or injury
C. Appear as pale yellow spots with red borders
Herpes Simplex(Cold Sores
I. Description
A. Is a recurrent viral infection that affects the skin and mucous membranes.
B. Herpes type I commonly produces cold sores and fever blisters
II. Symptoms and Signs
A. Blisters can be found on lips and inside mouth
1. Form painful blisters
III. Treatment
A. No known cure
Thrush
I. Etiology
A. Caused by Candida albicans a fungus of the mouth
1. Also causes vaginitis
B. Causes a burning sensation in the mouth
C. Caused by lowered resistance, treatment with antibiotics, cancer treatment, etc
Diseases of the Gastrointestinal Tract

Gastroesophageal Reflux Disease(GERD

I. Description
A. Contents of stomach or duodenum are regurgitated into the esophagus
II. Symptoms and Signs
A. Belching, burning sensation in the chest
III. Etiology
A. Can result from overeating, pregnancy, or weight gain that causes the lower esophageal
sphincter to relax
B. Patients with a hiatal hernia are prone to GERD
IV. Treatment
A. Treatment
B. Elevate head of bed about 6 inches
C. Eat a light meal 4 hours before bedtime
D. Nothing to eat 3 hours before bedtime
E. Weight loss
F. Limiting or eliminating alcohol and no cigarettes
G. Use of an H2-receptor antagonist or a proton pump inhibitor
Esophagitis
I. Description
A. Inflammation of the esophagus
II. Symptoms and Signs
A. Burning in chest
III. Etiology
A. Caused by reflux due to defect of cardiac sphincter
IV. Treatment -bland diet for a while and antacids
A. No known prevention
Esophageal Cancer
I. Etiology
A. Risk factors include-Cigarette smoking alcohol increase, drinking very hot beverages, eating
food containing N-nirtoso compounds, betel nut chewing, and poor nutrition
Gastric and Duodenal Ulcers
I. Description
 A. Mucus membrane is worn away
II. Symptoms and Signs
A. Heartburn, indigestion, pain, fullness
B. Most common ulcer found in the duodenum
III. Etiology
A. Heliobacter pylori may be cause
B. Second cause may be nonsteroidal antiinflammatory drugs
IV. Treatment
A. Treatment requires rest, change in diet and lifestyle
B. Drug treatment may include H2 receptor blocking agents, tranquilizers, sedatives, antacids, etc
C. Surgery may be necessary
Gastritis
I. Description
A. Inflammation of the lining of stomach
II. Etiology
A. pain, fullness, belching, and loss of appetite
B. Main cause is H pylori
C. Aspirin +, alcohol, smoking, infectious disease, stress, and mechanical injury damage the lining
D. Chronic gastritis associated with peptic ulcer
Gastric Cancer
I. Japan has highest incidence
II. H pylori early in life a cause
III. Family history, dietary factors and lots of acid increase risk
IV. Diagnosis - usually begins as an ulcer
Acute Appendix
I. Symptoms and signs
A. Has no known function
B. Classic symptoms include abdominal pain, around navel, localized in right lower quadrant
C. Patient may become nauseated, may vomit, have a fever, diarrhea, or constipation
Hiatal Hernia
I. Description
A. Is a defect in the diaphragm that permits a segment of the stomach to slide into the esophagus
II. Symptoms and Signs
A. Cardiac sphincter malfunctions and stomach contents are regurgitated into esophagus
III. Treatment
A. Dietary modifications, antacids, lose weight, drug therapy, no smoking, no lying down before 4
hr. after a meal, and elavate the head
Abdominal Hernia
I. Description
A. Organ protrudes through abdominal opening in abdominal wall
B. Inguinal hernia
1. A loop of bowel protrudes into the inguinal canal
a. Fills scrotal sac in males
C. Strangulated hernia
1. Blood flow has been stopped and gangrene can set in
D. Umbilical hernia
Crohn Disease
I. Description
A. Is a chronic inflammatory disease of the alimentary tract
1. Also called ileitis
II. Signs and Symptoms
A. Chronic diarrhea, cramping and maybe weight loss, anorexia, and fever
Ulcerative Colitis
I. Description
A. Is an inflammatory bowel disease
II. Signs and Symptoms
A. More common in women than men and in the Jewish population
Diverticulosis
 I. Progressive and common with age
II. Defects in muscular wall of large bowel
Diverticulitis
I. Inflammation of one or more diverticula
II. Fecal matter becomes trapped in one or more diverticuli
Colorectal Cancer
I. Etiology
A. Risk factors include a history of large adenomatous polyps, diabetes, colitis, Crohn disease or
radiation, cigarette smoking, physical inactivity, obesity, alcohol, and eating red meat
DISEASES OF THE LIVER, BILLARY TRACT, AND PANCREAS

Cirrhosis of the Liver

I. Description
A. Is a chronic, degenerative, and irreversible disease
II. Etiology
A. Most common cause is chronic alcoholism, malnutrition, hepatitis, toxic chemicals, and
congestive heart failure
Hepatitis A
I. Description
A. Is a highly contagious and mild liver infection
II. Etiology
A. Is transmitted by the fecal-oral route from contaminated food, water, and stool
Hepatitis B
I. Etiology
A. Transmitted through percutaneous and perimucousal routes
1. Many come through sexual contact or blood exchange from sharing of contaminated
needles
Hepatitis C
I. Symptoms and Signs
A. Considered a widespread epidemic and is most common blood borne infection in the US
B. 50% don’t know how they got it
II. Treatment
A. No cure
Cancer of the Liver
I. Etiology
A. Primary cancer of the liver is rare in more developed areas of the world
B. Usually develops as a metastasis for another site in the body such as the colon, lung, breast, or
prostate
Gallstones
I. Description
A. Is a common condition in which there is an abnormal presence of calculi or gallstones that form
in the bile
II. Prevention
A. A low fat diet may help to prevent attacks of biliary disease

DISORDERS OF NUTRIENT INTAKE AND ABSORPTION

Malnutrition
I. Description
A. Is caused by primary deprivation of protein energy, or secondary to deficiency diseases

Anorexia
I. Description
A. Is linked to a psychological disturbance in which hunger is denied by self-imposed starvation,
resulting from a distorted body image an and a compulsion to be thin
II. Symptoms and Signs
A. The typical patient is a female adolescent who is meticulous and a high achiever
Bulimia
I. Description
A. Is a behavioral disorder characterized by recurring episodes of binge eating followed by self-
induced vomiting or purging, usually in secret.