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alterations of intestinal motility
- diarrhea
- constipation
- intestinal obstruction
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Intestinal obstruction
- partial or complete blockage of the intestinal lumen of the small or large bowel
- obstruction prevents the passing of fecal matter
- there is backup pressure due to gas and fluid accumulation, which causes vomitting
- gas and fluid causes distention of abdominal cavity
- lumen distention which causes ischemia (can lead to necrosis)
- necrosis can leaf to perforation (causes peritonitis)
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Types of intestinal obstruction
- intussuception
- valvulus
- inguinal hernia (strangulated hernia)
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Intussusception
- intestinal bowel obstruction
- is a telescoping or invagination of a portion of the bowel into an adjacent distal portion
- proximal bowel gets stuck in distal bowel when passing bolus/fecal through peristalisis
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Valvulus
- is twisting of the bowel on itself, causing intestinal obstruction and blood vessel compression
- The two most common sites for the development of volvulus are the cecum and the sigmoid colon
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inguinal hernia
- also called strangulated hernia
- piece of bowel drops into inguinal canal
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diarrhea
- An increase in the frequency and fluidity of bowel movements.
- It is usually a primary sign of gastrointestinal tract disorders.
- acute and chronic
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acute diarrhea
last less than 4 days
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chronic diarrhea
last more than 3 weeks
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constipation
- A condition of having small, infrequent, and difficult bowel movements
- failure to respond to the urge
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dietary deficiency
results in low fiber
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peritonitis
- an inflammation of the peritoneum.
- caused by enteric bacterial invasion or chemical reaction
- can lead to toxemia or septic shock (dilation)
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enteric bacteria
reside in the GI tract
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Malsbsorption syndromes
- failure of the GI tract to absorb or normally digest one or more dietary constituents
- ie ciliac sprue
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Celiac disease
- also called celiac sprue
- intolerance of gluten, a protein in wheat and wheat products
- leads to a Tcell response that causes an inflammatory response
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intestinal cancer
adenomatous polyps and colorectal cancer
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polyps
- any protrusion into the lumen of the GI tract.
- may be benign or malignant
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colon
site that has more primary tumors than any other organ in the body
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adenomatous polyps
- most differentiated
- constant mitotic division results in mutation of cells
- **polyps-mutated cells that continue rapid mitotic division
- **progress to form tubular adenoma (5%) or velous adenoma (40%)
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colorectal cancer
- vast majority is from malignant transformation of polyps
- high fat intake may be a cause
- increased risk with ulcerative colitis
- occult bleeding (microscopic)
- stool occult blood screening test needed
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