GI Pathologies

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GI Pathologies
2010-12-05 02:40:36
GI pathology

description of different GI Pathologies
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  1. achalasia
    • failure of the LES to relax
    • after swallowing, dysphagia (difficulty swallowing)
    • lack of peristalsis->
    • distended esophagous with chest discomfort and pain
    • cause: absence of nerve
    • supply to the esophagus, chronic inflammation may lead to GERD or pneumonia,
    • increases risk of cancer
    • neuronal loss is
    • unknown/idiopathic
  2. Peptic Ulcer Disease
    • breakdown of mucosa of
    • stomach or small intestine (usually in duodenum)

    • Cause: increased HCl and
    • pepsin secretions, 70-80% of pts have H.pylori infection, remaining % can be
    • due to drugs, genetics, psychological stress, smoking

    • H.pylori survives by
    • releasing neutralizing agents around itself (urease-> converts urea to
    • bicarb and ammonia), causes ulcers by their metabolic by-products, secretes
    • cytotoxins and enzymes (protease, phosolipase, urease) damage mucosa

    • H.pylori can be transmitted
    • fecal-oral, or orally
  3. Gastro-esophageal Reflux Disease (GERD)
    gastric contents reflux into esophagus due to a poor functioning LES

    Causes: irritation to esophageal mucosa with subsequent retrosternal burning sensation (heartburn)

    Can be due to hiatal hernia, alcohol, overweight, pregnancy, smoking, medications, etc

    LES can be inhibited by alcohol, chocolate, garlic, mint flavors, tomato based foods, etc

    • Barrett’s esophagus: metaplasia (conversion of
    • one mucosal epithelium to another) esophageal epithelium (strat squamous) -> gastric epithelum (simple columnar) pre-cancerous condition
  4. Appendicitis
    • Acute inflammation of the
    • vermiform (worm-like) appendix, common reasons for emergency abdominal surgery in children is appendicitis

    Sx: Abdominal pain, very important!

    Cause: not clear, viral infection, obstruction from gallstone or stool, narrowed appendix, bent or kinked, cancer can obstruct surrounding area
  5. Inflammatory Bowel Disease (IBD)
    • chronic condition characterized by 2 entities: lots of abd. pain
    • crohn’s disease: inflammation of the small intestine towards the ileum (last part)
    • ulcerative colitis: inflammation of the large intestine

    Cause: idiopathic

    Crohn’s disease (ileitis, enteritis): develops during adolescence, can develop in other areas (large intestine, oral cavity, esophagus, stomach, duodenum, appendix or anal canal)

    Sx: diarrhea, rectal beeding, weight loss, fever

    Inflamed areas are separated by normal segments, which initially occur in mucosal areas along w/ shallow ulcers-> can lead to fibrosis and a thick rigid gut wall-> narrows gut lumen denying food passage and impairment of food absorption

    Loss of digestion/absorption-> hypoproteinemia (abnormal blood protein), avitaminosis (insufficiency of one or more vitamins in diet), malnutrition, possible steatorrhea (passage of large amt of fat in feces due to failure to digest and absorb it)