GASTROINTESTINAL (GI)
FUNCTION & DISORDERS
L Dr , Assistant P
K Oakley, Assistant P
GI TRACT STRUCTURE
REVIEW
•D System - P
•U tract: mout , esophagus, stomach
•M tract: sma intestine (duodenum, jejunum,
)
•L : lar (ce , colon, r ,
canal)
•A or : salivary glands, liver, g
, and pancr (hepatobiliary system)
GI TRACT STRUCTURE
REVIEW
•W struc :
•I mucosal la
•S layer – digestive enzymes to
lumen
•M e - and cir
layers
•S la – visc peritoneum
MAIN ACCESSORY ORGANS
•L
•G
•P
GI TRACT FUNCTION
INVOLVES:
•N s innerv
•M & S
•H action
•I Flo
PROCESSES:
1. I
2. D
3. A
4. E
A FEW OF THE GI DISORDERS
•A /Nausea/V /Diar
•D
•GERD
•IBS & IBD (C ’s vs UC)
•I Colitis
ANOREXIA/NAUSEA/VOMITING
•A : of appetite
•N : , conscious se fr stimulation of
vomiting ; may or may not pr vomiting
•V (Emesis): a for expulsion of stomach
DIARRHEA
•D : (WHO) – of t or mor stools per
or passing mor stools than nor for the .
•A diar illnesses:
• associated wit Infection (viral or bacterial)
•L than 2 wee
•C Diar
•O associated with IBD, IBS, M syndr
•P 4 or mor
W to describe
condition
CHRONIC DIARRHEA
C :
•H luminal
•I secr pr
•I conditions
•I conditions
CHRONIC
DIARRHEA
>
4
weeks
©
Blood,
Pus,
Fever
®
(Non-Inflammatory
)
—
{
+/-
Fecal
WBCs
?]
?
(
Inflammatory
)
1
IBD
Stool
on
Gap
e
Crohn's
eUC
<
50
>
50
\
+
faring
with
Radiation
Immunotherapy
?
Bile
Acid
Diet
lons
ya
e
CCY
©
Sorbitol
at
°
Mg
Malignancy
e
Ileal
Dz/Resection
e|,
Lactase
eatin
¢
Colon
cancer
e
FODMAP
(some)
e
Lymphoma
oO
Invasive
Infections
°
Antibiotics
+/-
Steatorrhea
¢
Metformin
8%
Fatty
+
Fecal
fat
°
Bacteria
Medications
(TB,
Aeromonas)
T
Thyroid
Hormone-Secreting
Malabsorptive
°
IBS
¢
Viral
(CMV,
HSV)
J
¢
Autonomic
‘
¢
Carcinoid
e
Celiac
dz
e
Parasitic
°
viPoma
e
SIBO
Enteropathy
(DM)
(Entamoeba,
Schisto)
¢
Gastrinoma
¢
Tropical
Sprue
Villous
Adenoma
¢
Giardia
e
Bile
Acid
Microscopic
Colitis
Maldigestive
Protein
Losing
Enteropathy
°
Pancreatic
Insuff.
://clinicalpr .com/dx-schema-chr -diar -2/
DYSPHAGIA
D in swal
•P C :
•N is (lesions of CNS, such as
; damage to cranial )
•C or str
•A disease
DYSPHAGIA
•C mani :
•C , coughing, sensation of food “sticking”
•M a content int the lungs
•D :
•E , swa studies
DYSPHAGIA
•T :
•D on cause and type of alt function
•M need dilation or sur pr
•N considerat :
•M diet consiste and eating met
•S path consultation
•S patient in bed
GASTROESOPHAGEAL REFLUX
DISEASE - GERD
•B movement of stomac content thr
or incompetent lower eso sphincter
•I the W societies, 10-20% affected
•M affect low esopha , oral cavity/
lungs
GASTROESOPHAGEAL REFLUX
DISEASE - GERD
•O mor 2x weekly
•P Causes:
•D em of the st = incr gastric
and pr
•T br categories:
•W esophageal mucosal damage (ie – B
)
•W esophageal damage
NORMAL,
HEALTHY
ESOPHAGUS
ESOPHAGUS
DAMAGED
BY
PROLONGED
ACID
3
4
EXPOSURE
‘
BARRETT'S
DYSPLASTIC
ESOPHAGEAL
ESOPHAGUS
TISSUE
BARRETT'S
CANCER
ESOPHAGUS
GASTROESOPHAGEAL REFLUX
•H - onset
•30 60 af
•E onset
•P in the epigastric
that radiates to
thr , shoulder, or
M
•A lar me
•A alcohol use and smoking
•E meals s up
•A r position
hours af a meal
•A bending for long periods
•S with the elevated
•L we if overweight
CONDITIONS CAUSING ALTERED INTESTINAL
FUNCTION
•Irritable bowel disease
•Inflammatory bowel disease
•Infectious Colitis
•D
•A
•A in motility
•M syndr
•C of the colo and r
IRRITABLE BOWEL SYNDROME – IBS
•P o r symptoms of a
•A bowel function
•V complaints of fla , bloatedness
•N a anor
•C or diar
•C ? A or depr co
INFLAMMATORY BOWEL DISEASE - IBD
•C ’s D
•A , granulomatous type
that affect any ar of the
tract fr the m to the anus
•U Coliti (UC)
•A of the colon
WIRY
Sela
eRe)
hi
ae
Crohn’s
Disease
Limited
to
the
large
Anywhere
in
Gl
tract,
intestine/colon
(from
gum
to
bum)
Location
of
inflammation
Patches
of
inflammation
found
in
large
sections
of
the
bowel
inflammed
areas
are
continuous
with
no
patchiness
Pattern
of
inflammation
Typically
in
the
Typically
in
the
lower
left
abdomen
lower
right
abdomen
Appearance
of
inflammation
Location
of
Pain
Ulcers
penetrate
Ulcers
penetrate
the
the
inner
lining
of
the
entire
thickness
(several
abdomen
only
layers)
of
the
abdominal
lining
Bleeding
a
e
\.
Common
during
bowel!
movements
Uncommon
To
learn
more
visit
CDHF.ca
IBD -
CROHN’S
VS UC
GOAL WITH IBD/IBS?
STOP THE DIARRHEA
TREAT THE INFLAMMATION
INFECTIOUS ENTEROCOLITIS:
INFECTIONS OF THE INTESTINE
•V Infection
•R
•B I
•C difficile
•E coli O157:H7 I
•P I
•E.
INFECTIOUS ENTEROCOLITIS
•V vs B
C Symptom: Diar , dehydrati
•D – L go!
•T th patho
•F th infection
•M de
Right
hepatic
ducts
ommon
hepatic
duct
Cystic
duct
Gallbladder
Minor
duodenal
papilla
Mayor
duodenal
papilla
Duodenum
Accessory
pancreatic
duct
Left
hepatic
ducts
Pancreatic
duct
Pancreas
LIVER AND HEPATOBILIARY SYSTEM
://medicine.tulane.edu/tulane-doctors/sur /hepatobiliary- - /hepatobi -p -disease-
/disord
PORTAL
CIRCULATION
B fr the GI tract,
, and pancr
to the li
the portal vein
moving into the
cava for r to
heart.
F P ’ P , 10
, pg 1119
PATHOLOGIC CONDITIONS AFFECTING
THE HEPATOBILIARY SYSTEM
•I fr drugs and to
•I , inflamma , and immune
•M disor
•N
LIVER AND HEPATOBILIARY
SYSTEM DISORDERS
•H
•A a Non-alcoholic Liver D
•C
•P Hypertension
•G disease
•P
LIVER AND HEPATOBILIARY SYSTEM
-LIVER FAILURE
•S/S to synthesis and storage functions
•G
•P
•L /cholester
•B
•S/S to metabolic and e functions
•A acids
•S
•D
•B - Jaundice
HEPATITIS
•V H
•H A
A & E – F /oral transmission
B, C, D – T via /body fluids
•A Immune Hepa (AIH) L for the
!
CAUSES OF HEPATITIS
•A disor
•R to drugs a to
•I disor
•M , infectious mononucleosis, salmonellosis, and
•H viruses that a liver cells
hepatocytes
•D cellular injury and induction of immune
against t viral antigens
SYMPTOMS
OF
HEPATITIS
A
@
Jez
Jaundice
Reduced
Dark
urine,
appetite
\
pale
poop
Weakness,
fatigue
Nausea
and
vomiting
Pain
in
the
right
side
of
Digestive
the
abdomen
disorders,
¢
.
or
diarrhea
4
Joint
pain
COM
India
Ki
Pharmacy
5MinuteSchool.com
i
Hepatitis
Be”
Inflammation
of
the
Liver
Hepatitis
Hepatitis Hepatitis Hepatitis Hepatitis
C
DE
Hepatitis
A
Virus
Hapetitie
B
Virus
Hepatitis
C
Virus
Hepatitis
D
Virus
Hepatitis
E
Virus
IeEX
Us
ontact
Blood-to-Blood
Transmission
“
Fecal-Oral
Route
Cont
senna
saan
2
Te
|
7
|
Can
only
be
infected
with
Hepatitis
Pigrealbelochi
tac
Symptoms:
(Ale
ia
;
‘f
sa
eo
=
enn,
Liver
Cirrhosis?
If
you
have
Hepatitis
B
already
Loss
of
appetite
oe
a
ia
ee
a
a
oa
Liver
Cancer?
Hepatitis
D
resides
INSIDE
Hepatitis
B
Symptoms:
rrnosis
oO
Ver!
°‘&i
=
|
Aapegncanates
Greater
RISK
of
Liver
Failure
/2undice
ain
Cices
Liver
Cancer:
Fluclike
cvmptome
INCREASED
RISK
+
PROGRESSION
TO
LIVER
CIRRHOSIS
ausea
,
unl
m
m
a
:
Malaise
(General
discomfort)
ne
oe
TRANSMISSION
Fatigue
Jaundice
(yellow
skin)
Contaminated
Needles
CHRONIC
STAGE:
6
WEEKS
RECOVERY
TIME
Sexual
contact
WEAK
IMMUNE SYSTEM
PREGNANCY
GREATER
RISK:
FULMINANT
LIVER
FAILURE
CIRRHOSIS
No
permanent
damage
to
liver
ALCOHOLIC & NONALCOHOLIC
LIVER DISEASE
A Disease – include:
•F disease
•A hepa
•C
•N fatty live disease
•W ? Not clearly und
•F associated wi : DM, Obesity, Hyperlipidemi
CIRRHOSIS
•M be associate with both Alcoholic and Non-
liver disease
•H fr with Alcohol
•F t r functioning liver tiss .
•F bands constrict tissue, disrupts blo flow
•L to P H , biliary obstruction, li failur
PF
Fatty
Liver
Healthy
Liver
Liver
Fibrosis
Stages
of
Liver
Damage
Cirrhosis
Oe
Lil
ae
eral
rrimreis
|
..
—_
iy
Po
CIRRHOSIS
•C manifestations vary
•M be NO disease is far
•S
•W loss
•A
•W
•A
•D is a fr pr
•JAUNDICE
PORTAL HYPERTENSION
•P Hyperten – obstruction of blood flow
the liver
•C
•A
•S
•H encephalopa
•E varices
GALLBLADDER DISEASE
•A : disten , pear- sac that st and
Bile
•C of or is sti by ingest F in the
.
•D :
•C , - ga stones
•C - infla
PANCREATIC SECRETIONS
•C pr enzymes that down foods
•S include:
•T (and others) –br down dietary pr
•A - B star and glycogen
•L -which hydr neutr fats into
fatty
•T pancr enzymes ar secr in the inactive
a become activa in the intestine.
Causes
of
acute
pancreatitis
Other
causes:
¢
Abdominal
trauma
¢
Medications
«
Genetic/anatomical
variants
¢
High
triglyceride
levels
¢
High
calcium
levels
©
2013
Mechanisms
in
Medicine
Inc.
PANCREATITIS
A : R pr the pancr
due to pr activation of the pancr
C : fr – pr gall stones or al abuse
C : I … des of e
(fibr ) and, later, des of the en
C : Long-ter alcohol abuse long-sta b of
duct.
“>
Salivary
glands
Mouth
Esophagus
Liver
Stomach
Gall
bladder
=
Pancreas
intestine
Anus
THE END
