Term
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Definition
Lower esophageal sphincter may be incompetent or become relaxed.
Motility disorder
increased intragastric pressure
Pyloric stenosis causing delayed emptying of stomach
increased volume and production of gastric secretions (gastric acid and pepsin) |
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Term
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Definition
| Type1 diabetes, heavy lifting, crushing chest injury, abdominal surgery, smoking,caffeine,alcohol,high fat diet,obesity,pregnancy,large meals,tight belts,prolonged nasograstric intubations,hiatal hernia |
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Term
| Risk factors (GERD) from drugs |
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Definition
drugs affecting autonomic nervous
anticholinergic and beta blockers: cause bronchi spasms and slows down paristalsis
drugs effecting cardiovascular calcium channel blockers (for HPTN)
Meperdine (demoral) causes relaxing spincter. |
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Term
| GASTROESOPHAGEAL REFLUX DISEASE |
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Definition
| backflow of gastric content into the esophagus, increase of gastric acid in esophagus. Sometimes increase with age |
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Term
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Definition
Dyspepsia 75% of PT (indigestion), heart burn or pyrosis (burning sensation), Chest pain in neck,mandible,shoulders,upperarms.
that pain response to nitrates,
regurgition(sour taste)dysphasia(pain in speech) odynophagia(pain on swallowing),belching,feeling of fullness in throat,sore throat, esophagitis. |
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Term
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Definition
endoscopy-fast before test twilight sedation, this is invasive and need consent.
barium swallow-take pictures in esophagus, no meds or IV fast before test |
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Term
| diet modifications for GERD |
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Definition
avoid irritating foods (pepper,paprika,mustard)
follow low fat diet
eat 3 reg meals, avoid large meals
avoid spicy foods
avoid caffeine,beer,carbonated beverages,food containg peppermint or spearmint,milk |
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Term
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Definition
| high fiber foods: peeled apples,bran cereal,brown rice,carrots,dried figs andapricots,lettuce,peaches,peas,seedles grapes,whole wheat bread. |
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Term
| six other things a patient can do with GERD |
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Definition
avoid smoking(it decreases the secretion of bicarbonate from the pancreas into the duodenum increasing acidity)
avoid eating and drinking 2 hrs. before bedtime.
maintain normal body weight
avoid tight clothes. elevate head of bed 6-8 inches.
avoid bending lifting coughing |
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Term
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Definition
nissen fundoplication (also treat hiatal hernia) the fundus of the stomach is wrapped around the distal esophagus and sutured to its self
Only problems with this surgery gas bloat syndrome |
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Term
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Definition
deep ulcerations
esophageal strictures and obstructions
barretts esophagus (linning of esophagus is altered) leads to esophageal cancer |
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Term
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Definition
no organic cause(12%of population occuring more in women have it)
effects motor activity in lg and sm bowel may be aeffected.
changes in intensity of perstalsis that pushes fecal matter forward
neurological regulatory system may affect peristalsis
food,infection,irritation or vascular or metabolic disturbance may affect peristalsis
stress,depression,anxiety,high fat diet along with stimulating or irritating foods |
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Term
| symptoms of Irritable Bowel Syndrome |
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Definition
diarrhea,constipation
hyper secretion of mucus
abdominal pain,bloating,tenderness or flatulence
straining,urgency or sensation of incomplete evacuation
nausea, vomiting,anorexia,depression, anxiety or fatigue headache |
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Term
| diagnostic test for irritable bowel syndrome |
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Definition
lower gastrointestinal tract: colonoscopy,sigmoidoscopy,proctoscopy
barium enema
drink prep (go lightly) before test dont put over ice.
dangers are perforating colon at risk for infection. |
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Term
| goal of planning and immplementing for patient with IBS |
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Definition
| pain relief, control diarrhea constipation reduce stress |
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Term
| diet modifications and things to avoid with IBS |
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Definition
avoid irritating foods,sorbitol or fructose. eat well balanced high fiber (30-40 g/day) diet
eat at regular times and no fluids with meals but drink at least 8-10 cups a day of fluid (2400ml)
avoid alcohol smoking. Exercise and reduce stress. |
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Term
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Definition
anticholinergics (dicyclomine HCL (Bentyl))slows down peristalsis
hydrophilic colloids (bulk laxatives)metamucil
antidiarrheals (lomotil or imodium) |
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Term
| stomach cancer 9 risk factors |
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Definition
native amern, hispanics, blacks and asians are predisposed
men
chronic inflammation of stomach
pernicious anemia
gastric polyps
carcinogens in food (smoked foods,pickled foods,salted fish,meats and nitrates (hot dogs,lunchmeat)
achlorhydria(lack of hydrochloric acid in stomach)
gastric ulcers
previous subtotal gastrectomy |
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Term
| adenocarcinoma (stomach cancer) |
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Definition
involve mucus producing cells of the stomach(usually distal portion)
most common form. In early stages involves mucosal and submucosal layers.
It spreads to tissues and lymph nodes surrounding the stomach(liver,pancreas,esophagus,duodenum)
later metastasis to lungs and ovaries. |
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Term
| symptoms early and late of stomach cancer |
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Definition
few early symptoms, early satiety
anorexia
indigestion
feeling of fullness and pain after meals
Late symptoms:
nausea,vomiting,fatigue,weight loss
anemia,gastrointestinal bleeding and blood in stool
enlarged lymph nodes and palpable abdominal mass |
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Term
| diagnostic tests and lab tests for stomach cancer |
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Definition
macro or microcytic anemia(decreased iron or vitamin b12)
positive occult blood in stool
hypoalbuminemia
elevated (CEA)carcinoembryonic antigen (should be <5)
upper GI(barium or contrast)
CT scan
endoscopy and biopsy |
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