DISEASE
DEFINITION
CAUSE
Gastroesophageal
Reflex
reflex of chyme from
stomach into lower
esophagus
lower esophageal sphincter
incompetence
CF: vomiting, coughing, lifting,
bending
heart burn, chyme
regurgitation, dysphagia,
substernal px
Hiatal Hernia
sliding of stomach thru
diaphragm into thoracic
cavity
erosion of stomach lining
Acute Gastritis - erosion of
superficial epithelium
autoimmune disease affects
elderly
drugs, Helicobacter Pylori,
Staphylococcal enterotoxin,
alcohol, caffeine
see Gastritis
stomach px, nausea,
vomiting, bleeding
rest, diet, stop
drugs
antibodies to parietal cells,
instrinsic factor, gastric
cells; achlorhydria,
pepsinogen, deficiency in
instrinsic factor secretion
usu. asymptomatic
antibiotics
Gastritis
Chronic
Gastritis aka
Atrophic
Gastritis
Chronic Antral
Gastritis
bacteria; aka Helicobacter
Gastritis, Infectious Gastritis
Peptic Ulcers
very common gastritis
located in distal part of
stomach
circumscribed ulceration of
mucous membrane of lower
esophagus, stomach, or
duodenum
Duodenal
Ulcers
more common, benign, in
young ppl, stress (spring/fall)
Helicobacter Pylori, hyper-secret.
of acid & pepsin
Gastric Ulcers
in older ppl, may be
malignant
Acute
Appendicitis
inflammation of vermiform
appendix
Helicobacter Pylori, severe
stress, smoking, drugs,
coffee/tea, alcohol, spicy + fatty
foods, acidic foods
bacterial infection
CF: obstruction of lumen,
twisting, lymphoid hyperplasia
Pseudomembranous
Enterocolitis
acute inflammatory bowel
disorder associated with
prolonged use of antibiotics
S/S
exposure of mucous membrane
of esophagus, stomach,
duodenum to acid & pepsin
-toxin producing bacteria
resistant to antibiotics multiply
-cell necrosis, prod. of mucous,
fibrin, inflam. cells occurs
-exudate on surface of lg. and/or
sm. intestine develops
Dg
Complications
endoscopy
develop into
adenocarcinoa
Ulcers in Gen:
clinical
symptoms,
endoscopy, xray, gastric
analysis
Tx
Ulcers in Gen:
bleeding (occult
or massive),
hematemesis,
melena,
perforation,
obstruction
Ulcers in Gen:
diet, bed rest,
antacids,
histamin receptor
block agents,
elimin.
Helicobact.,
surgery
perforation
leading to
peritonitis,
abscess
formation
surgery
remissions/exacerbactions
, pain in epigastic area,
awakens patient, relieved
by food
pain (after eating),
bloating, nausea, vomiting
pain, nausea, vomiting,
diarrhea, low-grade fever,
leukocytosis
rapid diarrhea
change in
antibiotics, fluid
replacement
DISEASE
DEFINITION
CAUSE
S/S
Peritonitis
acute inflammation of
visceral and parietal
peritoneum
localized or diffuse abd.
pain; abd. distention; abd
tenderness, rebound
tenderness, m. spasm;
fever, tachycardia, chills,
tachpynea; leukocytosis
Ulcerative
Colitis
chronic inflam. and ulcerative
disease arising in colonic
mucosa, char. by bloody
diarrhea; affects lower part
colon; affects ppl. 20-40 yrs
-bacteria from intestinal tract:
penetrating after perforation of
appendix or peptic ulcer, compl.
of abd. surgery, cholecytitis,
diverticulitis, colitis, infarcted
bowel
-spread of pelvic inf.
-rupture of ectopic preg.
-penetrating wounds
unknown
RF: family history; Jewish ,
whites; infection (virus, bact.);
immunologic factors
Patho:
erosionulcerabscessnecro
sis
diarrhea w/ purulent
mucus & blood in
intervals; abd. cramps,
fever, dehydration; weight
loss, anemia
Crohn’s
Disease
chronic transmural inflamm.
disease aff. distal ileum &
colon; affects young adults;
runs in family
unknown ( autoimmune, dietary
factors, bact., smoking)
“irritable bowel” for yrs,
chronic diarrhea, abd.
pain, fever, anorexia,
weight loss, right lower
quadrant mass.
Colonic
Diverticulosis
dev. of sm., multiple,
outpouchings thru muscular
wall of colon; location:
sigmoid colon
rel. to aging & low fibre diet
pain, diarrhea, bleeding
Irritable Bowel
Syndrome
motility disorder of sm. & lg.
intestine char. by abd. pain,
constipation/diarrhea, abd.
bloating as reaction to
stress; common (more
among ♀)
no anatomic cause; occurs in ppl.
w/ inherited ↑ sensitivity to
gatrointest. motility; emotional
factors: diet, drugs, hormones
(precipitate/heighten motility);
anxiety, depression, somatization
disorders may be present
abd. distress, var. in stool
consistency; bloating,
flatulence, nausea;
headache, fatigue;
depression, anxiety,
difficulty w/ mental
concen.; fibromyalgia,
dyspareunia,
temporomandibular jt.
synd.; symp. occur in
awake patient; triggerd by
stress
Dg
Complications
Tx
shock
surgery, antibi.
clinical symp.,
x-rays,
sigmoideoscopy
anal fissures,
hemorrhoids,
perirectal
abscesses;
colon
obstruction;
perforation
x-ray,
endoscopy
obstruction;
development
fistulas &
abscess; dev. of
cancer
(due:chronic
infl., stress)
anti-inflammatory
drug,
corticosteroids,
surgery; disease
usu. chronic
w/repeated
exacerbations &
vemissions
anti-infl. drug,
corticosteroids,
immunosuppress
ive drug,
surgeryobstruction,
abscess or
fistulas
diet; (For Diverticulitis):bed rest,
IV alimentation,
antibiotics,
surgery
may lead to
diverticulitis
(inflam. of
diverticulum)perforation,
abscess or
fistulas
formation
history; made
after excl. of
other diseases
(tumours, bact.
inflam, ulcers,
etc.)
stress relief; reg.
phys. activity;
improv. of eating
habits; sedative,
antidepressant,
psychotherapy,
anticholinergic
drug
DISEASE
DEFINITION
CAUSE
CarcinomaStomach
assoc. w. gastritis or stom.
ulcer; arises-gastric mucosa;
spreads in stomach wall;
metastasizes into region.
lymph nodes and liver
polyp: protrusion from
mucosal surface
loss of appetite, wt. loss, abd.
discomfort, pain, anemia, abd.
mass (occur late)
Colonic
Polyps
Viral Hepatitis
diffuse inflam. disease of
liver cause by diff. viruses
Fulminant
Hep.
massive hepatic necrosis;
complication of hep. B or C;
dev. 6-8 wks after initial
symp. of viral hep.
Alcoholic Liver
Disease
(ALD)
Fatty Change
(ALD
change of liver after long,
heavy ingestion of booze
Alcoholic Hep.
Cirrhosis
(ALD)
accum. fat in hepatocytes;
reversible w/cessation of
booze
inflam., degeneration,
necrosis of hepatocytes
fibrosis & nodular
regeneration of hepatic
tissue; end stage of most
serious chronic liver disease;
dev. takes months-years
Clinical Types:
Hperplastic polyp-sm., may
cause bleeding
Pedunculated adenoma-most
common type
Villous adenoma-raised, broadbased mass
Patho: inflam. w/liver cell
necrosis; infiltration by
monocytes; obstruction of bile
canaliculi→cholestasis→obst.
jaundice
S/S
Dg
Complications
x-ray;
gatroscopy,
biopsy
surgery
none; bleeding; altered
bowel mvt.
Tx
surgery
Prodromal Phase: no
symptoms; anorexia,
nausea, vomiting; malaise,
fatigue, arthralgias,
headache, fever, cough,
wt. loss. Icteric Phase:
jaundice, dark urine, claycoloured stool. Recovery
Phase: serum enzymes
(ALT, AST) elevated;
serum bilirubin increased
(in lab. findings for Dg)
confusion, stupor, coma;
intestinal bleeding,
cardioresp. insufficiency,
venal failure; elevated
blood ammonia, increase
prothrombin time
anorexia, nausea, liver
enlargement
alcoholism, chronic hep. (B, C);
biliary cirrhosis, hemosiderosis
fatigue, wt. loss, anorexia,
fever, abd. pain, jaundice
nausea, anorexia;
hepatomegaly,
splenomegaly
w/hypersplenism; anemia,
leukopenia,
thrombocytopenia;
jaundice, spideranigiomas,
gynecomastia (firm or hard
liver when palpated)
elevated serum
enzymes &
bilirubin;
↓serum
albumin,
prolonged
prothrombin
time; biopsy
portal
hypertension,
ascites, GI
hemorrhage
(esophageal
varices); hepatic
encephalopathy
alcohol
abstinence, diet;
liver
transplantation
DISEASE
DEFINITION
CAUSE
Cholelithiasis
&
Cholecystitis
presence of gallstones &
inflam. of gallbladder; formed
from cholesterol, bilirubin,
calcium
Biliary Colic: from migration of
gallstones w/obstruction of cystic
or common duct
Pancreatitis
inflamm. pancreas; worse
than inflamm. of other
organs; enzymatic necrosis
of pancreas & surround.
adipose tiss. present
oversecretion of pancreatic
juice & obst. of pancreatic
duct; occurs after ingestion
of heavy meal w/ booze
Acute
(hemorrhagic)
Pancreatitis
Chronic
Pancreatitis
chronic alcoholics; similar to
cirrhosis
Mild Panc.
can be caused by gallstones
or trauma
primary tumor; occurs as
complication of nonalcoholic
cirrhos.
abd. organs: colon, stomach,
pancreas. from other:
leukemia, lymphoma
adenocarcinoma (cancer
dev. from “head” of organ);
dev. in head of pancreas
Hepatocarcinoma
(tumor of liver)
Metastases
(liver tumor)
Carcinoma of
Pancreas
S/S
Acute Cholecytitis: pain,
high fever, leukocytosis,
rebound tenderness.
Biliary Colic: severe P,
irradiating to mid-upper
back; vomiting, jaundice
Dg
Complications
Diff. Dg:
pancreatic, MI,
acute
pyelonephritis
in R kidney
Dg.: ultrasound,
cholecystogram
Acute
Cholecytitis
↑serum
amylase &
lipase concen.
severe abd. pain, irradiating to
back, persist for days; nausea,
vomit, fever, leukocytosis (wbc);
peritonitis, paralytic ileus, shock
or semicoma
abd. pain, malabsorption,
diabetes
asymptomatic; hepatomegaly
(nodular liver), jaundice, ascites,
wt. loss
cigarette smoking, pancreatitis
biopsy
pain, jaundice, wt. loss,
ascites
Tx
antibiotics for
inflamm.,
laparoscopic
surgery; admin.
of drugs (to
dissolve)
evacuation of
food from
stomach; admin.
of drug blocking
juice secretion;
painkillers,
parenteral
nutrition
pancreatic
enzymes, Tx of
diabetes, diet