Term
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Definition
| increase in frequency, liquidity, and volume of stools |
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Term
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Definition
Large Volume.
Non-absorbable substances in the intestines which draw water from the body into the intestinal lumen by osmosis. |
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Term
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Definition
Excessive mucosal secretion of fluids and electrolytes.
Often caused by bacterial enterotoxins. |
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Term
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Definition
Related to a decrease transit time and resultant diminished reabsorption of fluid from stool.
Caused by small intestine resection and DM neuropathy. |
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Term
| Potential causes of abd pain |
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Definition
Mechanical stimulation
Inflammation
Ischemia |
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Term
| Mechanical stimulation abd pain |
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Definition
stretching, distension, or tension from adhesions of encapsulatead organs such as liver bowel and gallbladder.
Abd organs not sensitive to cutting/tearing/crushing. |
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Term
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Definition
| Caused by infection by bacteria, fungus, or parasite that causes the release of bradykinin, serotonin and histamine, all of which stimulate nerve endings, causing abdominal pain. |
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Term
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Definition
| Caused by impeeded blood flow to organs. |
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Term
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Definition
aka somatic
Localized and intense
Corresponds to skin dermatomes close to surface of skin.
Carried by sensory nerves. |
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Term
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Definition
Arises from the organs themselves
Felt as a more diffuse, dull, mild or vague discomfort.
Poorly localized.
Carried by sympathetic nerve fibers. |
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Term
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Definition
Viceral pain felt at a distance from the affected organ.
d/t shared spinal segments for sensory nerve expression. |
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Term
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Definition
Characterized by hematemesis- bright red blood or coffee ground (digested blood).
Found in esophagus, stomach, duodenum. |
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Term
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Definition
Characterized by hematoschezia (bright red blood), melena (dark, tary digested blood), or occult (very small amt may not change color of stool) blood.
Found in jejunum, ileum, colon, or rectum. |
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Term
| Gastroesophageal reflux disease (GERD) |
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Definition
Reflux of chyme from the stomach to the esophagus through the lower esophageal sphincter (LES).
Occurs as a result of weakening or relaxation of the LES and may be related to increased intrabdominal pressure, inc estrogen in pregnancy, obesity, delayed gastic emptying, hiatal hernia, pyloric stenosis or edema.
Severity depends on stomach contents and how long it is in contact with esophagus.
Pain worse with lying down.
CM: heartburn and dyspepsia(trouble swallowing), & regurg of acid. |
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Term
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Definition
Break, or ulceration in the protective mucosal lining of the lower esophagus, stomach or duodenum.
Risk Factors: H.pylori, habitual NSAID use, smoking, advanced age, chronci disease, decreased immunity, stress (severe illness, trauma, burns...).
2 types: duodenal ulcers, gastric ulcers |
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Term
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Definition
Most frequent peptic ulcer.
Causes: H.pylori which inc. gastric secretion of pepsin and acids, and NSAIDs which decrease secretion of bicarb.
CM: chronic intermittent epigastric pain 30min-2hrs after eating when stomach is empty.
Pain relieved by eating food and antacids "pain-food-relief" pattern.
Exacerbation in spring and fall. |
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Term
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Definition
Abnormality in mucosal barrier permeability to Hydrogen ion (acid).
Causes: H.pylori, NSAIDS, Chronic gastritis.
Occur equally in men and women.
Usually between ages 55-65yo.
CM: "pain-food-relief" pattern, Pain immediatly after eating, anorexia, vomiting, weight loss. |
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Term
| 7 postgastrectomy syndromes |
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Definition
Dumping syndrome
Alkaline Reflux gastritis
Afferent loop obstruction
Diarrhea
Weight loss
Anemia-d/t dec absorbtion of b12,folate,iron = macrocytic anemia & iron defficiency anemia.
Bone disorders d/t altered calcium absorption = increased risk of fx. |
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Term
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Definition
Rapid emptying of partially digested food from surgically created residual stomach into the small intestine 10-20 min after eating.
CM: hypotension, weakness, pallor, cramping, nausea, vomiting, & osmotic diarrhea. |
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Term
| Alkaline Reflux Gastritis |
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Definition
Stomach inflammation caused by reflulx of bile and alkaline pancreatic secretions.
CM: nausea, billious vomiting, apin that worsens after eating and is NOT relieved by antacids. |
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Term
| Afferent loop obstruction |
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Definition
Obstruction caused by tumor, growth, volvus (invagination of intestine), hernia, adhesions or stenosis in the duodenal stump.
Requires surgery to fix. |
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Term
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Definition
a chronic inflammatory disease that causes ulceration of the colonic mucosa particularly the sigmoid and rectum.
Lesions appear in susceptible individuals b/w 20 and 40 years of age.
More severe in rectum and sigmoid.
Intermittent remission & exacerbation.
Cause unknowk, possibly infectious, genetic, or immunologic.
Risk factors: family hx, jewish decent, caucasian.
Less common in smokers.
CM: fever, tachycardia, frequent diarrhea, bloody stool, continuous crampy abd pain, dehydration. |
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Term
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Definition
Herniations or saclike outpouchings of mucosa through weak points in the muscle layers of the colon wall.
Most common site Sigmoid colon (L side). |
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Term
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Definition
Asymptomatic
Assoc. with decreased fiber intake and increased intake of highly processed foods.
Most common in people >60yo.
CM: usually vague or absent. L lower abd cramping, diarrhea or constipation, and flatulance. |
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Term
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Definition
Inflammation of diverticula
CM: fever, inc WBC, LLQ pain |
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Term
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Definition
Inflammation of the appendix
Most common surgical emergency.
Occurs at any age but commonly between 20-30yo.
Cause:Obstruction of appendix lumen with stool, tumor, or foreign body with secondary infection.
CM: epigastric or periumbilical pain that is vague at first then inc. in intensity over 3-4hrs. may subside then recur with shift in location ot RLQ (McBurnies point) with rebound tenderness and guarding. Fever, N/V.
Perforation, peritonitis, and abscess formation are the most serious complications. |
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Term
| Irritable Bowel Syndrome (IBS) |
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Definition
A functional gastrointestinal d/o. Sx cant be explained by presence of structural or tissue abnormality. DX based on symptoms.
More common in women and youth and middle age.
Associated with anxiety and depression.
characterized by abnormal gastrointestinal motility and secretion, visceral hypersensitivity, abn. immune response (post-infectious), overgrowth of intestinal flora, food allergy, and psychosocial factors.
CM: low abd pain, diarrhea or constipation, or alternating diarrhea/constipation, bloating, nausea. SX relieved with defecation and DO NOT INTERFERE WITH SLEEP |
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Term
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Definition
An energy imbalance, with energy intake exceeding energy expenditure. Body mass index (BMI) greater than 30.
Occurs in families and genotypes. |
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Term
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Definition
Apple shape
fat localized around abd and upper body.
Inc risk for metabolic syndrome (hyperglyceridemia, reduced HDL, and insulin resistance). |
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Term
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Definition
Pear shape
fat localized in thighs and buttocks. |
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Term
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Definition
Adipocytes secrete cytokines tht signal molecules that participate in neuroregulation of food intake, lipid storage, metabolism, insulin sensitivity, and female reproduction.
Excessive inc in fat cells causes dysfunction in regulation and interaction of these ormones and contributes to complications of obesity. |
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Term
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Definition
Psychologic and physiologic syndrome
Characterized by:
•Fear of becoming obese despite progressive weight loss
•Distorted body image: perception that it is fat when it is underweight
•Body weight 15% less than normal for age & height d/t refusal to eat
•Absence of 3 consecutive periods
**Watch for cardiac failure**
dx involves through history and physical exam to r/o other causes of anorexia and weight loss. |
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Term
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Definition
Characterized by:
•Recurrent, secretive episodes of obsessive binge eating
•Self-induced, secretive vomiting, use of laxative (purging type)
•2 binge-eating episodes per week for at least 3 months (purging type)
•Fasting to oppose the effect of binge eating or excessive exercise (non-purging type)
Weight will fluctuate within 10lbs but stay within normal range. |
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Term
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Definition
A yellow or greenish pigmentation of the skin caused by hyperbilirubinemia.
Causes: Extrahepatic obstruction, inrtahepatic obstruction, and excessive hemolysis. |
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Term
| Extrahepatic Obstruction jaundice |
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Definition
Obstruction of common bile duct.
Bilirubin is conjugated by the hepatocytes but cannot flow into the duodenum.
Bili accumulates in the liver and enters the bloodstream, causing hyperbilirubinemia.
Bili appears in the urine.
Stools may be light or clay colored because they lack bile pigments. |
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Term
| Intrahepatic Obstruction jaundice |
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Definition
Disturbances in hepatocyte function and obstruction such as cirrhosis or hepatitis.
Elevated levels of both conjugated & unconjugated bilirubin.
Stool normal or light colored. |
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Term
| Excessive hemolysis jaundice |
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Definition
Increased amount of unconjugated bilirubin is formed through metabolism of the heme component of destroyed RBCs.
Bili is not water soluble and is not excreted in the urine.
Jaundice of newborn. |
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Term
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Definition
Gallstones
2 types: cholesterol (common) & pigmented (assoc with cirrhosis and later in life).
Risk factors: fat, fair, fourty, female, genetic predisposition, pregnancy, rapid weight loss, The pill, HRT, Native American.
CM: may be vague epigastric & RUQ pain that radiates to back, heartburn, flatulence, fatty food/cabbage intolerance +Murphys sign (pressure over liver with inspiration causes sever pain). |
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Term
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Definition
Inflammation of gallbladder.
Caused by lodging of gallstone in cystic duct.
CM: Jaundice, fever, leukocytosis, elevated bilirubin and alkaline phosphatase levels.
May lead to pancreatitis. |
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Term
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Definition
Inflammation of pancreas.
Assoc with alcoholism, obstructive billiary disease (gallstones).
Gall stone blocks common bile duct (Ampulla of Vater), bile refluxes into pancreas and pancreatic enzymes autodigest pancreas.
CM: Epigastric or midabdominal pain is cardinal symptom, Fever, leukocytosis, N/V, abd distension, hypotension, shock (d/t hypovolemia), multiple organ faiure, and death. |
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Term
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Definition
Obstruction of pyloric sphincter.
Common d/o of early infancy
Higher incidence: mlaes, whites, full term infants.
CM: 2-3 weeks after birth, forceful projective vomiting immediately after eating, constipation, fluid/electrolyte imbalance, 70-90% of the cases a firm, small, movable mass approximately the size of an olive in felt in the right upper quadrant. |
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Term
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Definition
Congenital outpouching of all layers of the small intestine wall, usually in the jejunum or ileum, causing obstruction.
Most common congenital malformation of the GI tract.
Affects Males
Commonly asymptomatic, if symptomatic seen around 2yo or not until adulthood.
Most common sx is painless rectal bleeding. |
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Term
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Definition
Related to relaxation or incompetence of the lower esophageal sphincter from delayed maturity or impaired hormone response.
Frequency highest in premies
CM: excessive vomiting, aspiration pneumonia, failure to thrive week 1-6 of life. |
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Term
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Definition
Esophagus ends in a blind pouch, usually is accompanied by a fistula between the esophagus and the trachea.
Polyhydramnios is common in mothers of affected infants.
CM: pulmonary complications, cant feed.
Usually accompanied by other anomilies. |
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Term
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Definition
Absence or obstruction of intrahepatic or extrahepatic bile ducts- which might end in a blind pouch.
Patho: Cchromosomal abnormality, autoimmune response, or viral insult inutero that destroys bile ducts.
CM: jaundice at birth, hepatomegaly, acholic (clay-colored) stool, cirrhosis. |
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