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What makes up the upper GI system?
- mouth
- esophagus
- stomach
- duodenum
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What percentage of immune cells are found in the GI system?
70-80%
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What makes up the lower GI system?
- small intestine
- large intestine
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What are the changes that occur with aging on the GI system?
- constipation, incontinence, divericulitis
- oral changes: tooth decay and loss
- sensory changes: decreased appetite
- loss of muscle tone in alementary organs
- --decreased gastric motility
- --decreased blood flow
- --decreased nutient absorption
- --decreased volumn and acid content of gastric juices
- decreased intrinsic absorption: leads to B12 deficiency, can cause anemia and other issues
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Clinical manifestations of GI
- nausea and vomitting
- abdominal pain
- diarrhea
- anorexia
- constipation
- dysphagia
- heartburn
- belching
- GI bleed
- hematemesis
- melena
- hematochezia
- fecal incontinence
- fecal urgency
- pallor
- diaphoresis
- dizziness
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What are the different types of abdominal pain with the GI system?
- mechanical pain: stretching of wall of organ
- inflammatory: occurs with relase of mediators stimulating sensory nerve endings
- ischemic: occurs as tissue metabolites are released into an area of diminished blood flow
- referred: pain perceived in area distant from source
- epigastric with radiation to back:
- --harp intense pain behind breast bone
- --radaties to back
- visceral:
- --hollow organs are contracted forcefully and distending
- --difficult to localize
- --gnawing, burning, cramping, aching
- --assoc. with sweating, pallor, nausea, vomitting
- parietal:
- --inflammation of parietal peritoneum
- --steady aching, more severe
- --can be localized over involved structure
- arthralgia:
- --joint pain seen in inflammatory bowel disease
- --preceeded by GI symptoms
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Joint pain is:
- asymmetric, nondeforming, and nonerosive
- migratory
- < 5 joints involved
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Symptoms may lead to GERD if:
- burning sensation
- sour taste
- abdominal discomfort
- gas
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GI symptoms with pain in L shoulder
- Kehr's sign
- requires MD referral
- due to free air or blood in abdominal cavity
- classic symptom of ruptured spleen
- caused by trauma, laparoscopy, ectopic pregnancy
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GI pain with eating
- gastric ulcer pain begins 30-90 minutes after eating
- duodenal or pyloric ulcer pain 2-4 hours after eating
- --eating may relieve painb
- --often have night pain relieved by eating
- "intense boring" night pain assoc with cancer
- heartburn
- --burning sensation
- --sx of GERD
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Early satiety
- full after very few bites
- anorexia
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GI pain with swallowing
- odynophagia:
- pn with swallowing
- relieved in upright position (esophagitis or spasm)
- relieved in supine or NTG (assoc with activity, coronary ischemia)
- dysphagia:
- food sticks in esophagus
- achalasis
- --closer of lower sphincter
- neoplasm
- neurological disease with spasticity or rigidity
- pharmacology
- --antidepressants
- --antihypertensives
- --asthma
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GI problems involving feces
- melana
- bright red stools
- diarrhea
- constipation
- fecal incontinence
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What is melana
- black, tarry stool
- due to digested blood from upper GI tract
- esophageal varices
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What does bright red stool indicate?
- blood (all require medical referral)
- from distal colon or rectum
- hemorroids: blood on surface
- rectal fissures: blood on surface
- colorectal carcinoma: blood mixed in
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What are the causes of diarrhea?
- acute: infection (fever, cramps, blood)
- chronic: all require medical referral
- neoplasm - look for other signs
- irritable bowel syndrom
- laxative abuse
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