Guided Lecture Notes
Chapter 28: Disorders of Gastrointestinal Function
Learning Objective 1. Define dysphagia, odynophagia, and achalasia.

Define and list causes and clinical manifestations of dysphagia, odynophagia, and
achalasia (refer to PowerPoint Slide 8).
Learning Objective 2. Relate the pathophysiology of gastroesophageal reflux disease to
measures used in the diagnosis and treatment of the disorder in children and adults.

Define reflux, and identify causes of GERD (refer to PowerPoint Slide 8 and
Fig. 28-1).

Describe the pathophysiology, signs and symptoms, complications, diagnosis, and
treatment of GERD.

Explain how diagnosis and treatment of GERD differ in infants and children.
Learning Objective 3. State the reason for the poor prognosis associated with
esophageal cancer (refer to PowerPoint Slide 8).

Differentiate between the two types of esophageal cancer.

Describe the clinical manifestations, treatment, and prognosis of esophageal
cancer.
Learning Objective 4. Describe the factors that contribute to the gastric mucosal
barrier.

Describe the features that protect the mucous lining of the stomach, and explain
why the stomach does not digest itself.
Learning Objective 5. Differentiate between the causes and manifestations of acute and
chronic gastritis.

Define gastritis, and differentiate between the causes, clinical manifestations, and
treatment of acute and chronic gastritis (refer to PowerPoint Slide 9).
Learning Objective 6. Characterize the proposed role of Helicobacter pylori in the
development of chronic gastritis and peptic ulcer, and cite the methods for diagnosing the
infection.

Describe Helicobacter pylori and discuss its incidence (refer to PowerPoint
Slides 11–12 and Fig. 28-2).

Explain how Helicobacter pylori cause damage to the gastric mucosa.

Describe diagnostic methods and treatment for Helicobacter pylori infection.
Learning Objective 7. Describe the predisposing factors in the development of peptic
ulcer, and cite the three complications of peptic ulcer.

Identify risk factors for, and describe the most common locations and causes of,
peptic ulcer (refer to PowerPoint Slide 11).

Describe clinical manifestations and complications of peptic ulcer (refer to Fig.
28-3).
Learning Objective 8. Describe the goals for pharmacologic treatment of peptic ulcer
disease.

Discuss diagnosis and treatment of peptic ulcer.
Learning Objective 9. Cite the etiologic factors in ulcer formation related to ZollingerEllison syndrome and stress ulcer.

Compare the etiology, pathology, clinical manifestations, diagnosis, and treatment
of Zollinger-Ellison syndrome and stress ulcer.
Learning Objective 10. List risk factors associated with gastric cancer.

Identify risk factors for and incidence of gastric cancer (refer to PowerPoint
Slide 9).

Describe symptoms, diagnosis, and treatment of gastric cancer.
Learning Objective 11. State the diagnostic criteria for irritable bowel syndrome.

Review the structure and function of the intestines (refer to PowerPoint Slide 2).

Describe the incidence and the chronic, recurrent intestinal symptoms that lead to
a diagnosis of IBS.

Discuss diagnosis and treatment for IBS.
Learning Objective 12. Compare the characteristics of Crohn disease and ulcerative
colitis.

Differentiate between Crohn disease and ulcerative colitis with regard to
pathology, clinical manifestations, complications, and treatment (refer to
PowerPoint Slide 13, Table 28-1, and Figs. 28-4 and 28-5).
Learning Objective 13. Describe the common causes of infectious enterocolitis.

Identify common microbes that cause infectious enterocolitis.

Describe methods of contamination, clinical manifestations, diagnosis, and
treatment of infectious enterocolitis (refer to PowerPoint Slide 17).
Learning Objective 14. Relate the use of a high-fiber diet in the treatment of
diverticular disease to the etiologic factors for the condition.

Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment
of diverticular disease (refer to PowerPoint Slide 13 and Fig. 28-6).

Explain the rationale behind a high-fiber diet as a preventative measure against
diverticulitis.
Learning Objective 15. Describe the rationale for the symptoms associated with
appendicitis.

Discuss the incidence, pathology, clinical manifestations, diagnosis, and treatment
of appendicitis (refer to PowerPoint Slide 13).
Learning Objective 16. Compare the causes and manifestations of small-volume
diarrhea and large-volume diarrhea.

Review the structure and function of the GI tract.

Differentiate between small- and large-volume diarrhea with regard to causes and
clinical manifestations (refer to Chart 28-1).
Learning Objective 17. Explain why a failure to respond to the defecation urge may
result in constipation.

Define constipation, and identify populations that it is most likely to affect.

Differentiate between primary and secondary constipation, and discuss the
importance of responding to defecation urges.

Discuss diagnosis and treatment of constipation.
Learning Objective 18. Differentiate between mechanical and paralytic intestinal
obstruction in terms of cause and manifestations.

Compare etiology, pathology, clinical manifestations, diagnosis, and treatment of
mechanical and paralytic intestinal obstruction (refer to PowerPoint Slide 20 and
Figs. 28-7 and 28-8).
Learning Objective 19. Describe the characteristics of the peritoneum that increase its
vulnerability to and protect it against the effects of peritonitis.

Review the anatomy and physiology of the peritoneum, and identify those
features that make the peritoneum vulnerable to or able to protect itself against
peritonitis.
Learning Objective 20. Describe the symptoms that may indicate malabsorption
syndrome.

Define malabsorption and list common causes and affected sites (refer to
PowerPoint Slide 28 and Table 28-2).

Describe the signs and symptoms that lead to a diagnosis of malabsorption
syndrome.
Learning Objective 21. Describe celiac disease in regard to its etiology,
pathophysiology, manifestations, diagnosis, and primary treatment.

Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment
of celiac disease (refer to PowerPoint Slide 28).
Learning Objective 22. List the risk factors associated with colorectal cancer, and cite
the screening methods for detection.

Discuss the incidence and risk factors associated with colorectal neoplasms (refer
to Fig. 28-9).

Identify the most common types of intestinal neoplasms.

Explain the importance of screening and early detection, and discuss treatment
options for colorectal cancer.