Alterations in Gastrointestinal Functioning

HCR 240AB Jillane Ocano

Review anatomy and physiology of digestive system

Disorders of the GI tract

Anorexia: abnormal lack of appetite Nausea and vomiting Constipation Diarrhea Abdominal Pain Gastrointestinal bleeding
Upper and lower

Disorders of the Esophagus

Dysphagia
Mechanical, functional, achalasia

Gastroesophageal reflux disease (GERD) Hiatal hernia Cancer of the esophagus

Hiatal Hernia

Fundoplication

Disorders of the Stomach

Gastritis
Acute and chronic

Peptic ulcer disease Cancer of the stomach

Disorders of the Small and Large Intestines

Malabsorption syndromes
Pancreatic insufficiency Lactase deficiency Bile salt deficiency

Disorders of the large and small intestine

Ulcerative colitis Crohn disease Diverticular disease Appendicitis

Diverticular disease

Appendicitis

Disorders of the small and large intestine

Irritable bowel disease
Affects women 3X more than men Abd. Pain, constipation and diarrhea brought on by stress

Infectious colitis

Disorders of the small and large intestine

Colorectal cancer
Stages A limited to the bowel wall B extended through bowel wall C nodal metastases D distant metastases

 Colorectal cancer
Risk factors
Age > 50 yrs Family hx High fat, low fiber diet High ETOH intake Smoking Sedentary lifestyle Inflammatory bowel disease

Clinical manifestations
Anemia Blood in stool Change in bowel habits, stool appearance Palpable mass

Clinical manifestations of hepatitis and impaired hepatic function

Portal hypertension
Varices Splenomegaly Ascites Hepatic encephalopathy

Jaundice / icterus
hyperbilirubinemia

Disorders of the liver

Hepatitis
Viral, etoh, toxin exposure, idiopathic A, least severe, oral fecal transmission, B&C, more severe, parenteral / sexual transmission, carrier state

Cirrhosis Cancer of the Liver

Hepatocellular, cholangiocellular , secondary mets.

Ascites and jaundice

Viral Hepitatis
Prevention:
immunizations for Hep B and Hep A Immune globulin (6-8 weeks of passive immunity)

Reduced fat high calorie diet No ETOH

Active Hepatitis:
Antivirals
Epivir, Hepersa, ribavirin

Interferon

Anitemetics B vitamins, vitamin K

Disorders of the Gall Bladder

Cholelithiasis: gall stones
Cholesterol and pigmented

Cholecystitis: inflammation of the gallbladder or cystic duct

Cancer of the gallbladder

Disorders of the Exocrine Pancreas

Acute Pancreatitis
Chronic Pancreatitis Cancer of the Pancreas
Ductal adenocarcinoma

Gastrointestinal disorders specific to children

Cleft Lip / Cleft Palate

Pyloric Stenosis

Esophageal Atresia
Clinical Manifestations:
Maternal polyhydramnios Excessive salivation & drooling Coughing, Choking, Cyanosis, resp distress after feeding Abdominal distention

Hirschsprung Disease Congenital Aganglionic Megacolon

Clinical Manifestation of Hirschsprung Disease

Meconium ileus Refusal to eat Vomiting Abdominal distention Failure to thrive Constipation Entercolitis :explosive watery diarrhea, fever

Intussusception
Clinical Manifestations
Sudden acute abdominal pain colicky Vomiting red current jelly stools Palpable sausage shaped mass in RUQ

 Meconium ileus Cystic fibrosis