GI Disorders
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40 terms
Terms | Definitions |
|---|---|
 GERD | The backward flow (reflux) of GI contents into the esophagus. Cause relates to: increase gastric volume or infra-abdominal pressure, or decreased esophageal sphincter tone. Esophagus becomes inflamed due to refluxed gastric or duodenal contents; degree of inflammation varies. |
| GERD (Manifestations) | Heartburn, substernal or retrosternal burning sensation, dyspepsia, regurgitation, hypersalivation, dysphagia, and odynophagia. Other: chronic cough, asthma, atypical chest pain, belching, flatulence, bloating, N/V |
| GERD (Diagnostics) | 24-hr ambulatory pH monitoring, esophageal manometry, scintigraphy, EGD |
| GERD (Collaborative Care) | Patient education, nutrition therapy, lifestyle changes ie: HOB ^ 6", sleep in right lateral decubitus position, stop smoking, and alcohol consumption, avoid factors that increase intra-abdominal pressure, identify possible medication contributors. |
| GERD (medication therapy) | Antacids, alluminum or magnesium. Histamine receptor antagonists; e.g., Zantec, Pepcid. Proton pump inhibitors e.g., Prilosec, Prevacid Prokinetic drugs:reglan |
| Hiatal Hernia | Stomach protrudes through the esophageal hiatus of the diaphragm, sliding or rolling. Symptoms: Heartburn, regurgitation, pain, dysphagia, and belching. Symptoms are worse after eating or in recumbent position. |
| Hiatal Hernia (Complications) | Regurgitation, aspiration, hemorrhage, esophageal stenosis, hernia strangulation |
| Hiatal Hernia (Collaborative Care) | Non-surgical: Patient teaching, nutrition, wgt reduction, + measures as for GERD. Drug therapy: antacids, histamine receptor antagonist Surgical: Fundoplication |
| Gastritis | Mucosal inflammation worsened by histamine release and vagal nerve stimulation. HCl acid diffuses into the mucosa causing injury. |
| Acute Gastritis | Abdominal tenderness, bloating, hematemesis, melena, dyspepsia, intravascular depletion and shock. May r/t infection (H.pylori, E.coli or exposure to irritants e.g, NSAIDs |
| Chronic Gastritis | Vague C/O epigastric distress, anorexia, +/- pain w/ food, weight loss. A diffuse inflammatory process, heals without scarring; +/- ulcer formation or hemorrhage; multiple iritants. Type A: antibodies to parietal cells. Type B: associated w/ H. Pylori. Atrophic: older adults, exposure to toxins, h. pylori, or autoimmune factors. |
| Gastritis (Collaborative Care) | Identify and eliminate causative factors. H2 receptor antagonists, Mucosal barrier fortifier, antacids, vitamin b12, limit intake of trigger foods, stress reduction. |
| Gastritis (Surgical Management) | Partial gastrectomy, Pylorplasty, Vagotomy, Total gastrectomy (also used for peptic ulcer disease) |
| PUD (peotic ulcer disease) | A stomach or duodenal mucosal lesion caused when mucosal defenses impaired; relates to the effects of acid,pepsin, & h. Pylori. 3 types: Gastric, Duodenal, Stress |
| PUD (Complications) | Hemorrhage, perforation, pyloric obstruction, incurable disease. |
| PUD (Assessment) | Contributors, life-style, meds, diseases, diet, alcohol & tobacco. Document: type of pain, effect of eating on the GI symptoms, N/V, change in bowel pattern, fatigue/dizziness |
| PUD (Diagnostics) | Hgb/Hct, testing for H. Pylori, +/- chest and abdominal x-ray, or CT, EGD |
| PUD GI Bleed | Hematemesis: bright red blood or coffee ground. Stools: melana or occult bleed May C/O: epigastric tenderness, dyspepsia, abdominal pressure, fullness or hunger. |
| IBS (Irritable Bowel Syndrome) | A functional GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating. |
| IBS (Criteria) | Abdominal pain relieved by defecation or falling asleep. Pain rt changes in stool frequency or consistency, abdominal distention, the sense of incomplete evacuation of stool, the presence of mucus w/ stool passage |
| IBS (Collaborative Care) | 'symptom diary', identify triggers, management strategies, eliminate offending foods, nutrition consule, i.e., fiber, gluids, etc. Drug therapy: bulk forming laxatives, antidiarrheal agents, 5-HT4 antagonists, M3-receptor antagonists, tricyclic antidepressants |
| CRC (Colorectal Cancer) | The large intestine, most are adenocarcinomas. Rectal bleeding, anemia, and change in the stool; depends on tumor location. |
| CRC (diagnostics) | Hemoglobin and hematocrit are decreased, fecal occult blood test, possible increase of carcinoembryonic antigen (CEA), imaging |
| Stage 1 | tumor invades up to muscle layer |
| Stage 2 | Tumor invades to other organs; perforates peritoneum |
| Stage 3 | any level of tumor invasion, <4 regional lymph nodes |
| Stage 4 | Any level of tumor invasion; many lymph nodes affected with distant metastasis |
| CRC (Collaborative Care) | Radiation and drug therapy. Surgical management: minimally invasive surgery, colon resection, colectomy, abdominoperineal (AP) resection, Colostomy. |
| Ulcerative Colitis | Inflammation of the rectum, recto-sigmoid colon & +/- the entire colon with epithelial destruction= decreased absorptive surface; fluid/electrolyte loss, bleeding & diarrhea, and colon wall thickening. Remissions/exacerbations; increase colon cancer risk. |
| Ulcerative Colitis (Assessment) | Tenesmus, loose stools w/ blood/mucus. Major: bloody diarrhea & abdominal pain, poor absorption of vital nutrients |
| Ulcerative Colitis (Diagnostics) | Barium enema, sigmoidoscopy, CBC, electrolytes, total protein, albumin, stool specimens (blood, C/S) |
| Ulcerative Colitis (Complications) | Malabsorption, systemic immune response |
| Ulcerative Colitis (Collaborative Care) | Nutrition: increase cal/protein, decrease residue, vitamins, iron; elemental diet and parenteral nutrition Meds: Sulfasalazine, steriods and anti-inflammatory, immunomodulators, antidiarrheal drugs. Surgery: TOtal colectomy w/ continent ileostomy or total colectomy w/ ileoanal anastomosis |
| Crohn's Disease | A chronic inflammatory disorder affecting any part of lower GI (jejunum, terminal ileum, & colon); exacerbation and remissions. Transmural inflammation w/ skip lesions, deep longitudinal ulcerations & strictures (cobblestone appearance) +/- abscess or fistula. Malabsorption of vitamins and nutrients, Tumor Necrosis Factor (TNF) correlates w/ disease |
| Crohn's Disease (Manifestations) | Diarrhea, fatigue, abdominal pain, decrease weight, fever |
| Crohn's Disease (Complications) | Obstructions, fistulas, perforations, abscesses. Malabsorption & nutritional deficiencies; fat soluble vitamins; gluten intolerance (barley, wheat, rye), systemic: arthritis, liver/GB & renal disorders |
| Crohn's Disease (Diagnostics) | Lab studies: electrolytes, CBC, serum protein, stool specimens. Studies: barium, endoscopy/capsul endoscopy, colonscopy |
| Crohn's Disease (Collaborative Care) | Diet: low residue & roughage, high calories and protein. Considerations: gluten and lactose intolerances. Medications: Sulfasalazine: principal drug, decreases GI inflammation, antimicrobials, prevent or treat secondary infection, corticosteriods:acute flare-ups, decrease inflammation, immunonosuppressants: non responders to other meds. Other: biologic therapies (inhibit TNF), antidiarrheals, hematinics & vitamins Surgery: laparoscopy, small bowel resection and ileocecal resections, stircturoplasty. Surgery DOES NOT cure |
| Diverticular Disease | The presence of many abnormal pouchlike herniations in the wall of the intestine. |
| Diverticular Disease (Assessment) | H&P, clinical manifestations, diagnostic assessment. Non-surgical management- rest, NPO, IV Fluids, IV antibiotics, nutrition therapy, drug therapy, avoid laxatives and enemas. |
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