lecture 12

• Dysphagia
• Esophageal pain
• Abdominal pain
• Vomiting
• Intestinal gas
• Alterations in Bowel patterns

Difficulty in swallowing, possible w/ pain (odynophagia)

Neuromuscular problems, altered esophageal, lower esophageal shphincter dysfunction space occuptying lesion (cancer)

heartburn (pyrosis), from reflux of gastric contents into esophagus

• (due to distention of esophagus or spasmsof esophageal
• musculature, also esophageal reflux)

acute w/ sudden onset or have a gradual development

also may be associated w/ a peripheral ulcer (diverticulitis)

expulsion of stomach contents, by diaphragm and abdominal muscles and reverse peristalsis of esophagus

constriction and diaphragm

belching, abdominal distention and flatus

eructation

small, infrequent, or difficult bowel movements

increase in frequency and fluidity of bowle movements

associated w/ acute infection, food allergies, and emotional stress

the sensation that food has become “stuck” behind the sternum

• be visceral (diffuse, poorly localized),
• somatic (sharp, well localized),
• or referred (at a distance from the source but in the same dermatome).

motility or lack of digestive enzymes

by swallowed air and bacterial action on nutritional substrates.

Lack of exercise, lack of dietary fiber, slowed peristalsis, and pathologic conditions that alter motility (e.g., obstruction) may produce constipation

increased amounts of poorly absorbed solutes in the intestine

to toxins that stimulate intestinal fluid secretion and impair absorption.

(mucus, blood, protein) results from inflammatory processes

Stomatitis

Acute Herpetic Stomatitis (cold sores)

• GERD
• Hiatal Hernia
• Mallory-Weiss Syndrome
• Esophageal Varices

Inflammation of oral cavity, caused by pathogens, trauma, exposure to irritants, and certain chemicals

• Cold sores
• infection remains dormant in trigeminal ganglia and can be reactivated by emotional or physical stressors

Gastroesophageal Reflux Disease

backflow of gastric contents into the esophagus, due to weakness of lower esophageal sphincter

defect in diaphragm that allows part of stomach to pass into thorax

Bleeding due to a tear in upper part of stomach or lower part of esophagus

75% are men w/ history of alcohol abuse

A complication of portal hypertension, generally due to cirrhosis from alcoholism or viral hepatitis

heartburn, chest pain, and dysphagia and may be precipitated by gastric overdistention or poor LES tone

sliding or rolling (paraesophageal)

coughing, straining, or esophagitis

inflammation of the stomach lining

Caused by ingestion of alcohol, aspirin, or irritating substances or by viral, bacterial, or autoimmune illnesses

• Helicobacter pylori infection causes chronic, superficial
• gastritis in all infected persons

NSAIDS, over use of tobacco and alcohol

may be asymptomatic, don’t know they have it , breath smells like urea, N/V post pradial discomfort (after eating discomfort) a good chance you loose ur appetite (anorexic) in severe cases may vomit up blood (hematemisis)

inflammation of stomach and small intestine

infection of lining by pathogenic organism (norwalk virus) or ingestion of bacterial endotoxins

atrophy of the gastric mucosa and the subsequent decreased production of HCI and intrinsic factor

violent

diarrhea, indegestion, and other types of GI disorders

injury to mucosa of esophagus, stomach or duodenum

bacteria (H. pylori and NSAIDs)

epigastric burning and pain relieved by food intake, most pain is when pts stomach is empty.

in sig # of pt w/ ulcers are asymptomatic due to pain tolerance or lack of pain molecule

w/ no warning at all. bleeding associated w/ perfusion

inflammatory disease of the mucosa of the colon and rectum, or uncertain cause

continuous

abdominal pain, diarrhea, and rectal bleeding

intermittent series of exacerbation and remissions

developing colon cancer

chronic inflammatory disorders of the bowel

distal colon (descending and sigmoid colon) due to autoimmune response

toxic megacolon requireing immediate surgery

inflammation of proximal colon and less often terminal ileum, affecting multiple sites in colon w/ healthy tissue intervening (skip lesions)

Granulomatous inflammation

perianal fissures, fistulae, and abscesses are common

toxic megacolon is less frequent

skip lesions, one point to anouther damaged then great condition and then damaged again

• bowel to bowel
• bowel to bladder
• bowel to vagina

an abnormal opening will eat away that the adjacent bowel can form btw any epithelial surface