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Chapter 13 - Gastrointestinal Pathophysiology
esophageal disorders - dysphagia; achalasia; reflux and inflammation dysphagia - failure to properly swallow; neuromuscular disorder; crilopharyngeal; can be caused by tumors crilopharyngeal - in the upper esophagus achalasia - ineffective peristalsis in lower esophagus; accompanied by gastric reflux reflux and inflammation - also called "heartburn"; caused by hiatus hernia hernia - an organ abnormally protrudes through an opening hiatus - a gap direct hiatus hernia - stomach pushes up into the hiatus of the diaphragm para esophageal hernia - does not cause reflux, but can cause necrosis in stomach
obstruction in the stomach - keeps things from moving out; pyloric valve/sphincter pyloric valve/sphincter - keeps stomach closed until it is ready to push chime to the small intestine pyloric stenosis - the valve becomes narrow and stiff; congenital disease in most cases; 4 times more common in males; can also be caused by chronic inflammation tumors of the stomach - adenoma; carcinoma; ulcerative; fungating adenoma - benign, glandular tumor carcinoma - cancerous, epithelial tumor ulcerative - tumor acts as an ulcer as it grows fungating - tumor grows in a mushroom shape; resembles a fungus; can cause obstruction signs and symptoms of stomach tumors - nausea; pain; anorexia; vomiting; weight loss; diarrhea; cachexia
perforation - ulcer has eaten through the organ wall; needs surgical repair small intestine disorders of absorption - gluten intolerance; Crohn's disease gluten intolerance - cannot digest it; destroys the villi in the intestine; lactose intolerance lactose intolerance - also called Celiac Disease; due to lack of lactase; causes bloating and gas; treat with lactaid Crohn's disease - regional enteritis; chronic inflammation; fibrous connective tissue forms; can spread to other parts of the GI tract causes of Crohn's disease - necrosis; hardening; destruction of villi; formation of fistulas; autoimmune disease fistula - abnormal opening between two epithelial surfaces; cause poor absorption treatments for Crohn's disease - inflammatories; manage diet; remove parts of the intestine effects of poor absorption - anemia; edema; hypocalcemia; malnutrition; diarrhea ways to diagnose poor absorption -
barium x-ray; excess fat in feces; d-xylose test barium x-ray - barium injected into the small intestine; if villi are not shown, it is indicative of poor absorption; villi should be shown and small intestine should look feathery steatorrhea - fat in feces; normal level is 6 g/day d-xylose test - xylose not digested; give in food, collect urine for 5 hours; 20% should show up in urine if absorbed; if not absorbed, then it remains in the gut obstructive disorders of the small intestine - Crohn's disease; tumors; volvulus; intussusception; adhesions; hernias volvulus - twisting of the small intestine, causing a kink intussusception - telescoping of the intestine adhesions - found after surgery; bands of connective tissue squeeze the intestine shut types of hernias - abdominal; femoral; inguinal abdominal hernia -
treatment for diverticulitis - antibiotics; remove part of the colon, if chronic how to diagnose diverticulitis - barium air contrast x-ray; fill the colon with air and give an x-ray, should show inflammation in the location where the colon is not blown up ulcerative colitis - general inflammation of the colon; involves mucosa and submucosa; no known cause; could be autoimmune signs and symptoms of ulcerative colitis - systemic inflammation; nausea; vomiting; diarrhea; blood in stool tumors in the colon - can be metastatic; effect the epithelium of the colon; adenocarcinomas annular tumor - ring shaped; cause obstruction; usually found in descending colon fungating tumor of the colon - grows like a fungus; most common in ascending colon signs and symptoms of colon tumors - pain; distention; diarrhea average motility in colon - 500-600 mL of fluid enters the colon per day; about 85% of the fluid is reabsorbed
motility disorders of the colon - diarrhea, constipation, and spastic colon diarrhea - not enough fluid is absorbed in the colon causes of diarrhea - inflammatory disorders; poor absorption in small intestine; bacterial infection; nervous disorders signs and symptoms of diarrhea - hypovolemia; electrolyte imbalances; metabolic acidosis constipation - too much fluid is absorbed, this causes atonic colon results of constipation - hemorrhoids and anal fissures hemorrhoids - varicose veins in rectum and anal canal anal fissures - cracks in skin around the anus due to hard fecal material spastic colon - called irritable bowel syndrome; rotation between diarrhea and constipation; can only learn to manage symptoms
