Term
| Pyloric stenosis (AKA Achalasia of the Pylorus) |
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Definition
| A disorder of unknown etiology characterized by hypertrophy of the circular muscle of pylorus causing narrowing and lengthening of the pyloric channel. |
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Term
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Definition
| The pyloric sphincter is thickened, firm( due to hypertrophy of the pyloric muscle) with distention of the stomach resulting in projectile vomiting and progressive electrolyte & nutritional disturbances. |
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Term
| Epigastric Pain of Gastrointestinal causes |
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Definition
Cholecystitis
Cholelithiasis
Gastritis
Peptic Ulcer Disease
Pancreatitis |
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Term
| Epigastric Pain of Vascular causes |
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Definition
Myocardial Infarction
Aortic Dissection
Mesenteric Ischemia |
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Term
| Epigastric Pain of other causes |
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Definition
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Term
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Definition
| Nonulcer Dyspepsia, Functional Dyspepsia, Gastritis, Duodenitis, Acid-Related Dyspepsia |
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Term
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Definition
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Term
| Associated symptoms of Dyspepsia |
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Definition
Abdominal bloating
Belching and Flatulence
Nausea
Halitosis |
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Term
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Definition
Functional Dyspepsia (Nonulcer Dyspepsia):
Peptic Ulcer Disease:
Gastroesophageal Reflux: |
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Term
| Percentage of dyspepsia patients from Gastroesophageal Reflux: |
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Definition
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Term
| Percentage of dyspepsia patients from Peptic Ulcer Disease: |
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Definition
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Term
| Percentage of dyspepsia patients from Functional Dyspepsia (Nonulcer Dyspepsia): |
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Definition
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Term
| Less Common Dyspepsia Causes |
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Definition
Biliary tract disease
Gastroparesis
Pancreatitis
Ischemic bowel disease
Intestinal Parasites |
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Term
| Types of Stomach infiltrative disease |
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Definition
Crohn's Disease
Sarcoidosis |
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Term
| Tupes of Abdominal Malignancy or Mass |
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Definition
Gastric Cancer
Esophageal Cancer
Pancreatic Cancer
Hepatoma |
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Term
| Types of Endocrine abnormalities |
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Definition
Endocrine abnormalities
Hypercalcemia
Hyperkalemia |
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Term
Types of
Carbohydrate malabsorption |
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Definition
Lactose Intolerance
Sorbitol intolerance
Fructose intolerance
Mannitol intolerance |
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Term
| Types of Systemic disease |
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Definition
Diabetes Mellitus
Thyroid disease
Parathyroid disease
Connective tissue diseases |
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Term
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Definition
Age of onset cut-off
Current age cut-off: age over 45-56 years
(Age over 35 years in men
Age over 56 years in women)
Dysphagia
Anorexia
Persistent Vomiting
Jaundice |
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Term
| Red Flags in Dyspepsia cont. |
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Definition
Palpable abdominal mass
Family History of Gastric Cancer
Prior Peptic Ulcer Disease history
Unexplained weight loss
(Rapid weight loss more than 6.5 pounds
Rapid weight loss >10% of body weight)
Signs of significant Gastrointestinal Bleeding
Anemia
Rectal bleeding or Melena |
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Term
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Definition
Inflammation of the stomach could be
acute or chronic. |
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Term
| Causes of Acute gastritis: |
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Definition
a. Non-infective irritants: alcohol, spicy food and sensitivity to aspirin.
b. Acute bacterial and viral infections especially in children. |
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Term
| Causes of Chronic atrophic gastritis: |
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Definition
| A metaplasia towards an intestinal type of epithelium is common. |
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Term
| The three major groups of gastritis are: |
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Definition
| 1.Erosive, hemorraghic or acute gastritis 2.Nonerosive, nonspecific gastritis 3. Specific gastritis |
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Term
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Definition
| An erosion is defined as an epithelial defect that does not penetrate beyond the muscularis mucosa. includes gastritis caused by virus, bacteria, fungi or parasites but is also a part of generalized diseases. |
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Term
| Nonerosive, nonspecific gastritis: |
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Definition
| may be caused by Helicobacter infection or by autoimmune causes. |
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Term
| Erosive, hemorraghic or acute gastritis : |
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Definition
| is caused by ingestion of drugs, trauma and physical agents (e.g. nasogastric tubes), vascular causes (ischemia) and stress lesions in seriously ill patients. |
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Term
| Common sites for Peptic ulcers |
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Definition
1- The stomach: a common site (gastric ulcer)
2- The first part of the duodenum: common (duodenal ulcer)
3- Esophagus: are rare and is called esophageal ulcer.
4- On the jejunal side of a gastroenterostomy.
5- In Meckel's diverticulum. |
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Term
| Gastric Ulcers Are associated with normal or even decreased secretion of |
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Definition
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Term
| Gadtric Ulcers Always associated with infection by |
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Definition
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Term
| Lack of _______ production is what causes an ulcer |
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Definition
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Term
| Predisposing factors to ulcers |
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Definition
1- Sex: males
2. Age: adolescence and adults
3 - Diet
4 - Aspirin
5 - Hyperacidity
6- Gastritis
7- Inheritance
8- Psychological factors
9- Tobacco
10- Hormones
11- Burns |
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Term
| Certain food may be ulcerogenic such as |
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Definition
| spiced food. Pickles hot liquids and fried food |
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Term
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Definition
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Term
| Aspirin and nonsteroid anti-inflammatory drugs may promote ulcer formation by |
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Definition
inhibiting synthesis of prostaglandins.
( Prostaglandins contribute to the integrity of the gastric mucosal barrier) |
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Term
| Glucagon: stimulate acid-producing cells and can produce this syndrome |
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Definition
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Term
| Steroids: decrease the viscosity of the |
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Definition
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Term
| Estrogen: may exert a protective function due to the fact that |
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Definition
| Women rarely develop peptic ulcers before the menopause. |
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Term
| Burns, abdominal injuries, surgical operations and fractures, may be followed by |
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Definition
| acute peptic ulcers, usually attributable to stress |
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Term
| Cerebrovascular disease may also lead to |
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Definition
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Term
common factors
responsible for inducing peptic ulcers |
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Definition
Abnormal vagal impulses
Infection
Hyperacidity |
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Term
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Definition
| Persons with prolonged hyperacidity especially at night when the stomach has emptied its contents into the duodenum are prone to develop ulcers, which are duodenal rather than gastric. |
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Term
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Definition
Hematogenous infection with organisms of low-grade virulence may cause inflammatory foci in the stomach wall leading to necrosis with subsequent digestion and ulcer formation.
100% have H. pylori infections |
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Term
| Why is the duodenum more at risk for developing ulcers compared to the stomach |
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Definition
| Duodenum does not have the thick mucus of the stomach |
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Term
| Neurogenic theory of peptic ulcers |
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Definition
| Abnormal vagal impulses from the hypothalamic region. Peptic ulcers are more common in patients with mental worry and strain. |
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Term
| The role of the neurogenic theory in the production of peptic ulcer: |
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Definition
a) vascular spasm and ischemia, which cause the initial area of necrosis
b) hypersecretion of the gastric juice
c) hypermotility, leads to removal of the protective layer of mucous, exposing the mucosa to the destructive action of the gastric secretion |
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Term
| Complications of peptic ulcers |
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Definition
| Hemorrhage, Perforation, Cicatricial contraction |
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Term
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Definition
due to erosion of thin vessels leading to hematemesis.
If hemorrhage is slight, occult blood appears in stools. |
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Term
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Definition
Is more common the anterior wall of the stomach or duodenum.
Perforation leads to either a sub diaphragmatic abscess or to generalized peritonitis |
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Term
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Definition
Due to gradual contraction of the fibrous base of the ulcer producing one of the following deformities:
a) Pyloric stenosis and great dilatation of the stomach.
b) Hour-glass stomach, if the ulcer is on the lesser curvature and the sear tissue pulls upon the greater curvature. |
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Term
| Gastric Irritants (risks for Peptic Ulcer Disease) |
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Definition
Aspirin
NSAIDS
Corticosteroids (prednisone)
Alcohol
Coffee and other caffeine sources
Tobacco abuse |
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Term
| Herbal preparations for peptic ulcers: |
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Definition
Garlic
Gingko
Saw Palmetto
Feverfew
Chaste Tree Berry
White willow |
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Term
| Anti-secretory Agents for peptic ulcers |
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Definition
H2 Blocker (e.g. Ranitidine)
Proton Pump Inhibitor (e.g. Omeprazole) |
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Term
| Carcinoma of stomach Precancerous factors: |
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Definition
1- adenoma and papilloma of the stomach
2- atrophic gastritis (intestinal metaplasia)
3- pernicious anemia (inability of body to use Vit. B12 and folate)
4- chronic gastric ulcer ( 1% or less become malignant)
5- more common among persons with blood group A |
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Term
| Carcinoma of stomach most common site is |
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Definition
| the prepyloric region, pyloric antrum and the lesser curvature. |
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Term
| Carcinoma of stomach least common site is |
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Definition
at the cardia and the body of the stomach
and is rare in the fundus. |
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Term
| Morbid anatomy of the stomach: |
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Definition
| Polypoid or fungating carcinoma, Malignant ulce, Infiltrating carcinoma |
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Term
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Definition
linitis plastica (leather bottle stomach)
Whole thing is cancer, nothing is left of original stomach |
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Term
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Definition
It is usually larger than 2.5 cm in diameter
with raised and everted edges |
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Term
| Polypoid or fungating carcinoma: |
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Definition
| a large soft fungating mass projects into the lumen of the stomach, associated with ulceration, hemorrhage and infection. |
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Term
| Effects of morbid anatomy of the stomach |
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Definition
1- Loss of appetite: early, due to infiltration of the muscular wall of the stomach, interferes with the gastric tone ( reduces the sense of appetite)
2-Bleeding (hematemesis)
3- Pyloric obstruction with vomiting
4- Occult blood in stools
5-Cancer cachexia: (loss of appetite, weight and marked anemia)
6-Gastric juice findings:
a. hypochlorhydria or achlorhydria ( due to mucosal destruction)
b. pyloric obstruction allows fermentation of the retained food and forms
lactic acid.
c) Cancer cells and blood cells can be detected. |
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Term
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Definition
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