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lack of appetite
-orexia = appetite
**is a sign of malignancy or liver disease
- Ex. Anorexia nervosa
- -is a loss of appetite associated with emotional problems such as anger, anxiety, and irrational fear of weight gain.
Abnormal accumulation of fluid in the abdomen.
**This condition occurs when fluid passes from the bloodstream and collects in the peritioneal cavity.
**Can be a sign of neoplasm or inflammatory disorders in the abdomen, venous hypertension caused by liver disease (cirrhosis), or heart failure.
- -Administration of diuretic drugs & paracentesis to remove abdominal fluid.
borborygmus (plural: borborygmi)
Rumbling or gurgling noise produced by the movement of gas, fluid, or both in the gastrointestinal tract.
**A sign of hyperactive intestinal peristalsis, borborygmi (bowel sounds) often are present in cases of gastroenteritis and diarrhea.
Difficulty in passing stools (feces).
**When peristalsis is slow, stools are dry and hard.
- -A diet of fruit, vegetables, and water is helpful.
- -Laxatives and cathartics are medications to promote movement of stools.
Frequent passage of loose, watery stools.
- **Abrupt onset of diarrhea immediately after eating suggests acute infection or toxin in the gastrointestinal tract.
- ** Untreated, severe diarrhea may lead to dehydration.
Difficulty in swallowing.
- **This sensation feels like a "lump in the throat" when a swallowed bolus fails to progress due to:
- --Obstrutive dysphagia (physical obstruction)
- --Motor dysphagia (esophageal peristalsis is not coordinated)
Gas expelled from the stomach through the mouth.
**Eructation produces a characteristic sound and also called belching.
Gas expelled through the anus.
**Flatulence is the presence of excessive gas in the stomach and the intestines.
Passage of fresh, bright red blood from the rectum.
**The cause is due to colitis or ulcers or polyps in the colon or rectum.
Yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood (hyperbilirubinemia).
- **Occur when:
- 1) Excessive destruction of erythrocytes, as in hemolysis, causes excess bilirubin in the blood.
2) Malfunction of liver cells (hepatocytes) due to liver disease
prevents the liver from excreting bilirubin with bile.
3) Obstruction of bile flow
, such as from choledocholithiasis or tumor, prevents bilirubin in bile from being excreted into the duodenum.
Black, tarry stools; feces containing digested blood.
**Sign in which blood has had time to be digested (acted on by intestinal juices) and results from bleeding in the upper gastrointestinal tract (duodenal ulcer).
Unpleasant sensation in the stomach associated with a tendency to vomit.
**Common causes are sea and motion sickness and early pregnancy.
- **Nausea and vomiting may be symptomatic of a
- -- perforation (hole in the wall) of an abdominal organ
- -- obstruction of a bile duct, stomach, or intestine
- -- exposure to toxins (poisons).
Fat in the feces; frothy, foul-smelling fecal matter.
**Improper digestion or absorption of fat can cause fat to remain in the intestine.
**This may occur with disease of the pancreas (pancreatitis) when pancreatic enzymes are not excreted.
**It also is a sign of intestinal disease that involves malabsorption of fat.
Inflammation of the mouth with small, painful ulcers.
**also commonly called canker sores.
- **Dental plaque results from the accumulation of foods, proteins from saliva, and necrotic debris on the tooth enamel.
- --- Bacteria grow in the plaque and cause production of acid that dissolves the tooth enamel, resulting in a cavity (area of decay).
- --- If the bacterial infection reaches the pulp of the tooth, root canal therapy may be necessary.
Inflammation of the mouth caused by infection with the herpesvirus.
**Painful fluid-filled blisters on the lips, palate, gums, and tongue, commonly called fever blisters
or cold sores
**It is caused by herpes simplex virus type 1 (HSV1).
**Herpes genitalis (due to HSV2) occurs on the reproductive organs.
- medication to relieve symptoms.
White plaques or patches on the mucosa of the mouth.
**This precancerous lesion can result from chronic tobacco use (pipe smoking or chewing tobacco).
Inflammation and degeneration of gums, teeth, and surrounding bone.
occurs as a result of accumulation of dental plaque
and dental calculus
(a yellow-brown calcified deposit on teeth).
- **In gingivectomy, a periodontist uses a metal instrument to scrape away plaque and tartar from teeth; any pockets of pus are then drained and removed to allow new tissue to form.
- -- Localized infections are treated with systemic antibiotics.
Failure of the lower esophagus sphincter (LES) muscle to relax.
- **Achalasia (-chalasia = relaxation) results from the loss of peristalsis so that food cannot pass easily through the esophagus.
- ---Both failure of the LES to relax and the loss of peristalsis cause dilatation (widening) of the esophagus above the constriction.
- Doc recommend a bland diet low in bulk and mechanical stretching of the LES to relieve symptoms.
Malignant tumor of the esophagus.
- **Most common symptom is difficulty swallowing (dysphagia).
- ---smoking and chronic alcohol use are major risk factors.
**Long-term irritation of the esophagus caused by gastric reflux is a premalignant condition called Barrett esophagus
- -surgery, radiation therapy, and chemotherapy
Swollen, varicose veins at the lower end of the esophagus.
- **Liver disease (such as cirrhosis and chronic hepatitis) caused increased pressure in veins near and around the liver (portal hypertension).
- ---This leads to enlarged, tortuous esophageal veins with danger of hemorrhage (bleeding).
- -drug therapy to lower portal hypertension
- -banding or tying off the swollen esophageal veins.
Malignant tumor of the stomach.
**Chronic gastritis associated with bacterial infection is a major risk factor for gastric carcinoma.
gastroesophageal reflux disease (GERD)
Solids and fluids return to the mouth from the stomach.
is the burning sensation caused by regurgitation of hydrochloric acid from the stomach to the esophagus.
**Chronic exposure of esophageal mucosa to gastric acid and pepsin (an enzyme that digests protein) leads to reflux esophagitis
- -antacid (acid-suppressive) agents
- -medication to increase the tone of the LES.
Protrusion of an organ or part through the muscle normally containing it.
- **A hiatal hernia occurs when the upper part of the stomach protrudes upward through the diaphragm.
- ---This condition lead to GERD.
- **An inguinal hernia occurs when a small loop of bowel protrudes through a weak lower abdominal muscle.
- ---Tx: Surgical repair of inguinal hernias is known as herniorrhaphy (-rrhaphy means suture).
Open sore in the lining of the stomach or duodenum.
- **A bacterium, Helicobacter pylori (H. pylori), is responsible for peptic ulcer disease.
- ---The combination of bacteria, hyperacidity, and gastric juice damages epithelial linings.
- -antibiotics, antacids, and agents to protect the lining of the stomach and intestine.
Abnormal tube-like passageway near the anus.
**often results from a break or fissure in the wall of the anus or rectum, or from an abscess (infected area) there.
Polyps (benign growths) protrude from the mucous membrane of the colon.
- **Two types of polyps:
- 1) pedunculated
- (attached to the membrane by a stalk)
- 2) sessile
- (sitting directly on the mucous membrane).
Adenocarcinoma of the colon or rectum, or both.
**can arise from polyps in the colon or rectal region.
--Diagnosis is determined by detecting melena (blood in stool) and by colonoscopy.
--Prognosis depends on the stage (extent of spread) of the tumor, including size, depth of invasion, and involvement of lymph nodes.
- -excision of a major section of colon with rejoining of the cut ends (anastomosis)
- -chemotherapy and radiotherapy are administered as needed.
Crohn disease (Crohn's)
Chronic inflammation of the intestinal tract (terminal ileum and colon).
--Signs and symptoms: diarrhea, severe abdominal pain, fever, anorexia, weakness, and weight loss.
**Both Crohn disease (or "Crohn's") and ulcerative colitis are forms of inflammatory bowel disease (IBD)
- -drugs to control symptoms
- -surgical removal of diseased portions of the intestine, with anastomosis of remaining parts.
Abnormal outpouchings in the intestinal wall.
- **Diverticula are pouch-like herniations through the muscular wall of the colon.
- ---when fecal matter becomes trapped in diverticula, diverticulitis can occur.
**Symptoms: pain and rectal bleeding
Painful, inflamed intestines commonly caused by bacterial infection.
**Often occurring in the colon
**results from ingestion of food or water containing bacteria (salmonellae or shigellae), amebae (one-celled organisms), or viruses.
**Symptoms: bloody stools, abdominal pain.
Swollen, twisted, varicose veins in the rectal region.
- **Varicose veins can be
- ---internal (within the rectum) or
- ---external (outside the anal sphincter).
**Pregnancy and chronic constipation, which put pressure on anal veins, often cause hemorrhoids.
Loss of peristalsis with resulting obstruction of the intestines.
**Surgery, trauma, or bacterial injury to the peritoneum can lead to a paralytic ileus (acute, transient loss of peristalsis).
Telescoping of the intestines.
**In this condition, one segment of the bowel collapses into the opening of another segment.
**It often occurs in children and at the ileocecal region.
**Intestinal obstruction with pain and vomiting can occur.
- -surgical removal of the affected segment of bowel with anastomosis frequently is necessary to correct the obstruction.
irritable bowel syndrome (IBS)
Group of gastrointestinal symptoms associated with stress and tension.
**Symptoms: diarrhea, constipation, bloating, and/or lower abdominal pain.
- Tx is symptomatic:
- -diet high in bran and fiber to soften stools and establish regular bowel habits.
Chronic inflammation of the colon with presence of ulcers.
- **This idiopathic, chronic, recurrent diarrheal disease (an inflammatory bowel disease) presents with rectal bleeding and pain.
- ---Often beginning in the colon, the inflammation spreads proximally, involving the entire colon.
**Patients with ulcerative colitis have a higher risk of colon cancer.
- -drug and careful attention to diet.
- -resection of diseased bowel with ileostomy may be necessary.
Twisting of the intestine on itself.
**Cases intestinal obstruction
**Symptoms: severe pain, nausea, vomiting, and absence of bowel sounds.
- -Surgical correction is necessary to prevent necrosis of the affected segment of the bowel.
Gallstones in the gallbladder.
**Calculi (stones) prevent bile from leaving the gallbladder and bile ducts.
**Many patients remain asymptomatic and do not require Tx; however, if a patient experiences episodes of biliary colic
(pain from blocked cystic or common bile duct), Tx may be required.
- -laparoscopic or minimally invasive surgery (laparoscopic cholecystectomy) is performed to remove the gallbladder and stones.
Chronic degenerative disease of the liver.
**results of chronic alcoholism, or viral hepatitis, or other causes.
**Lobes of the liver become covered with fibrous tissue, hepatic cells degenerate, and the liver is infiltrated with fat.
**Cirrh/o means yellow-orange, which describes the liver's color caused by fat accumulation.
Malignant tumor of the pancreas.
**Often occurs in men than in women.
- **Cause is unknown
- **Common in smokers and people who are obese.
**Symptoms: abdominal pain, fatigue, jaundice, and anorexia.
- (Whipple procedure).
Inflammation of the pancreas.
**Digestive enzymes attack pancreatic tissue and damage the gland.
**Other causes: chronic alcoholism, drug toxicity, gallstone obstruction of the common bile duct, and viral infections.
- -medications to relieve epigastric pain, intravenous fluids, and subtotal pancreatectomy if necessary.
Inflammation of the liver caused by a virus.
- **Hepatitis A
- --is a viral hepatitis caused by HAV.
- --a benign disorder spread by contaminated food or water and characterized by slow onset of symptoms.
- --complete recovery is expected.
- **Hepatitis B
- --is caused by the HBV and is transmitted by blood transfusion, sexual contact, or the use of contaminated needles or instruments.
- --severe infection can cause destruction of liver cells, cirrhosis, or death.
- --A vaccine that provides immunity is available and recommended for persons at risk for exposure.
- **Hepatitis C
- --is caused by HCV and is transmitted by blood transfusions or needle inoculation (such as among intravenous drug users sharing needles).
- --the acute illness may progress to chronic hepatitis and hepatocellular carcinoma.
***In all types, liver enzyme levels may be elevated, indicating damage to liver cells.
**Symptoms: malaise, anorexia, hepatomegaly, jaundice, and abdominal pain.