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PATHOLOGY OF THE DIGESTIVE SYSTEM

Terms in this set (41)

Anorexia
Lack of appetite.
Anorexia (-orexia = appetite) often is a sign of malignancy or liver disease.
Anorexia nervosa
is a loss of appetite associated with emotional problems such as anger, anxiety, and irrational fear of weight gain.
It is an eating disorder.
Ascites
Abnormal accumulation of fluid in the abdomen.

This condition occurs when fluid passes from the bloodstream and collects in the peritoneal cavity.
It can be a sign of neoplasm or inflammatory disorders in the abdomen, venous hypertension (high blood pressure) caused by liver disease (cirrhosis), or heart failure.

Treatment for ascites includes administration of diuretic and paracentesis to remove abdominal fluid.
Borborygmys (plural: borborygmi)
Rumbling or gurgling noise produced by the movement of gas, fluid, or both in the gastrointestinal tract.
Constipation
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.
Diarrhea
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.
Antidiarrheal drugs are helpful.
Dysphagia
Difficulty in swallowing.

This sensation feels like a "lump in the throat" when a swallowed bolus fails to progress, either because of a physical obstruction (obstructive dysphagia) or because of a motor disorder in which esophageal peristalsis is not coordinated (motor dysphagia).
Eructation
Gas expelled from the stomach through the mouth.

Eructation produces a characteristic sound and also is called belching.
Flatus
Gas expelled through the anus.

Flatulence is the presence of excessive gas in the stomach and the intestines.
Hematochezia
Passage of flesh, bright red blood from the rectum.

The cause of hematochezia usually is bleeding due to colitis or from ulcers or polyps in the colon or rectum.
Jaundice (icterus)
Yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood (hyperbilirubinemia).

Jaundice can 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; or (3) obstruction of bile flow, such as from choledocholithiasis or tumor, prevents bilirubin in bile from being excreted into the duodenum.
Malena
Black, tarry stools; feces containing digested blood.

This clinical sign usually reflects a condition 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).
A positive result o stool guaiac testing indicates blood in the stool.
Nausea
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 the bile duct, stomach, or intestine; or exposure to toxins (poisons).
Steatorrhea
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.
Aphthous stomatitis
Inflammation of the mouth with small, painful ulcers.

The ulcers associated with this condition are commonly called canker sores; the cause is unknown.
Dental caries
Tooth decay.

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.
Herpetic stomatitis
Inflammation of the mouth caused by infection with the herpesvirus.

Painful fluid-filled blisters on the lips, palate, and tongue, commonly called fever blisters or cold sores.
It is caused by herpes simplex virus type 1 (HSV1).
Treatment is with medication to relieve symptoms.
Herpes genitalis (due to HSV2) occurs in the reproductive organs.
Both conditions are highly contagious.
Oral Leukoplakia
White plaques or patches on the mucosa of the mouth.

This is precancerous lesion can result from chronic tobacco (pipe smoking or chewing tobacco).
Malignant potential is assessed by microscopic study of biopsied tissue.
Periodontal disease
Inflammation and degeneration of gums, teeth, and surrounding bone.

Gingivitis occurs as a result of accumulation of dental plaque and dental calculus or tartar ( a yellow-brown calcified deposit on teeth).
In gingivectomy, a periodontist uses a mental 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.
Achalasia
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.
Physicians recommend a bland diet low in bulk and mechanical stretching of the LES to relieve symptoms.
Esophageal cancer
Malignant tumor of the esophagus.

The most common symptom of esophageal cancer is difficulty swallowing (dysphagia).
Smoking and chronic alcohol use are major risk factors.
Long-term irritation of the esophagus caused by gastric reflux is pemalignant condition called Barret esophagus.
Surgery, radiation therapy, and chemotherapy are treatment options.
Esophageal varices
Swollen, varicose veins at the lower end of the esophagus.

Liver disease (such as cirrhosis and chronic hepatitis) causes increased pressure in veins near and around liver (portal hypertension).
This leads to enlarged, tortuous esophageal veins with danger of hemorrhage (bleeding).
Treatment includes drug therapy to lower portal hypertension and banding or tying off the swollen esophageal veins.
Gastric cancer
Malignant tumor of the stomach.

Chronic gastritis associated with bacterial infection is a major rosk factor for gastric carcinoma/
Gastric endoscopy and biopsy diagnose the condition.
Cure depends on early detection and surgical removal of the cancerous tissue.
Gastroesophageal reflux disease (GERD)
Solids and fluids return to the mouth from the stomach.

Heartburn 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.
Drug treatment for GERD includes antacid (acid-suppressive) agents and medication to increase the tone of the LES.
Hernia
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 can lead to GERD.
An inguinal hernia occurs when a small loop of bowel protrudes through a weak lower abdominal muscle.
Surgical repair of the inguinal hernias is known as heniorrhaphy (-rrhaphy means suture).
Peptic ulcer
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.
Drug treatment includes antibiotics, antacids, and agents to protect the lining of the stomach and intestine.
Anal fistula
Abnormal tube-like passageway near the anus.

The fistula often results from a break or fissure in the wall of the anus or rectum, or from an abscess (infected area) there.
Colorectal cancer
Adenocarinoma of the colon or rectum, or both.

Colorectal cancer can arise from polyps in the colon or rectal region.
Diagnosis is determined by detecting melen (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 the lymph nodes.
Surgical treatment may require excision of a major section of the colon with rejoining of the cut ends (anastomosis).
Chemotherapy and radiation are administered as needed.
Crohn disease (Chron's)
Abnormal outpouchings in the intestinal wall.

Diverticula are pouch-like herniations through the muscular wall of the colon.
When fecal matter becomes trapped in the diverticula, diverticulitis can occur.
Pain and rectal bleeding are symptoms.
Dysentery
Painful, inflammed intestines commonly caused by bacterial infection.

Often occurring in the colon, dysentery results from ingestion of food or water containing bacteria (samonellae or shigellae) , amebae (one-called organisms), or viruses.
Symptoms are bloody stools and abdominal pain.
Hemorrhoids
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 the anal veins, often cause hemorrhoids.
Ileus
Loss of peristalsis with resulting obstruction of the intestines.

Surgery, trauma, or bacterial injury to the peritoneum can lead to paralytic ileus (acute, transient loss of peristalsis).
Intussusception
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 within anastomosis frequently is necessary to correct the obstruction.
Irritable bowel syndrome (IBS)
Group of gastrointestinal symptoms associated with stress and tension.

Gastrointestinal symptoms are diarrhea, constipation, bloating, and/or lower abdominal pain.
On extensive examination, the intestines appear normal, yet symptoms persist.
Treatment is symptomatic, with a diet high bran and fiber to soften stools and establish regular bowel habits.
Ulcerative colitis
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.
Drug treatment and careful attention to diet are recommended.
Resection of diseased bowel with ileostomy may be necessary.
Patients with ulcerative colitis have a higher risk of colon cancer.
Volvulus
Twisting of the intestine on itself.

Volvulus causes intestinal obstruction.
Severe pain, nausea and vomiting, and absence of bowel sounds are clinical features.
Surgical correction is necessary to prevent necrosis of the affected segment of the bowel.
Cholelithiasis
Gallstones in the gallbladder.

Calculi (stones) prevent bile from leaving the gallbladder and bile ducts.
Many patients experiences episodes of biliary colic (pain from the blocked cystic or common bile duct), treatment may be required.
Currently, laparoscopic or minimally invasive surgery (laparoscopic cholecystectomy) is preformed to remove the gallbladder and stones.
Cirrhosis
Chronic degenerative disease of the liver.

Cirrhosis is commonly the result of chronic alcoholism, or viral hepatitis, or other causes.
Lobes of the liver become cover with fibrous tissue, hepatic cells degenerate, and the liver is infilrated with fat.
Cirrh/o means yellow-orange, which describes the liver's color caused by fat accumulation.
Pancreatic cancer
Malignant tumor of the pancreas.

Pancreatic carcinoma occurs more often in men than women.
Although the cause is unknown, it is more common in smokers and people who are obese.
Symptoms and signs are abdominal pain, fatigue, jaundice, and anorexia.
Surgical treatment is pancreatoduodenectomy (whipple procedure).
Pancreatitis
Inflammation of the pancreas.

Digestive enzymes attack pancreatic tissue and damage the gland.
Other etiologic factors include chronic alcoholism, drug toxicity, gallstone obstruction of the common bile duct, and viral infections.
Treatment includes medications to relieve epigastric pain, intravenous fluids, and subtotal pancreatectomy if necessary.
Viral hepatitis
Inflammation of the liver.

-Hepatitis A id a viral hepatitis caused by the hepatitis A virus (HAV).
It is benign disorder spread by contaminated food or water characterized by slow onset symptoms.
Complete recovery is expected.
-Hepatitis B is caused by the hepatitis B virus (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 or exposure.
-Hepatitis C is caused by the hepatitis C virus (HCV) and is transmitted by blood transfusions or needle inoculation (such as among drug users sharing needles).
The acute illness may progress to chronic hepatitis and hepatocellular carcinoma.

In all types, liver enzymes levels may be elevated, indicating damage to liver cells.
Signs and symptoms include malaise, anorexia, hepatomegaly, jaundice, and abdominal pain.
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