Transcript Gastrointestinal Disease

Gastrointestinal Disease
From An Introduction to Human
Disease Pathology and
Pathophysiology Correlations 7th Ed.
By Leonard V. Crowley
Types of Diseases Included in the
Gastrointestinal System
• Cleft lip and Cleft
Palate
• Teeth Abnormalities
• Neoplasia of the oral
cavity
• Gastritis
• Stomach Carcinoma
• Inflammatory Disease
of the Intestine
• Appendicitis
• Bowel Disturbances
• Diverticulitis and
Diverticulosis
• Intestinal Obstruction
• Tumors of the Bowel
• Hemorrhoids
Anatomy of the GI Tract
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Mouth (lips, face, tongue, teeth)
Esophagus
Stomach
Small intestine
Colon
Anus
Rectum
Cleft lip and Cleft Palate
• These are defects of the upper lip and jaw (cleft
lip) or the area between the nose and mouth or
palate (cleft plate).
• Such abnormalities occur in 1 in 1000 births with
high incidence in families with at least one child
with either abnormality.
• Treatment comes in the form of surgery. Speech
therapy is recommended in early childhood.
Teeth Abnormalities
• Missing teeth or extra teeth
• Loss of tooth enamel caused by antibiotic use
especially tetracycline
• Caries or tooth decay caused by dental plaque
• Periodontal disease (gingivitis and pyorrhea)
• Stomatitis (etiology: Candida albicans, alcohol,
hot or spicy foods, etc…)
What is the recommended hygiene to reduce
dental caries?
Neoplasia of the Oral Cavity
• Carcinomas which are found in squamous
epithelium of the cheek, tongue, lips,
palate, or throat are considered oral cavity
neoplasias.
Diseases of the Esophagus
Patients with esophageal disease experience
problems associated with swallowing and
episodes of choking.
Mucosa in the esophagus can be destroyed or
inflamed because of reflux esophagiatis.
Cardiospasm may result when the cardiac
sphincter fails to allow passage of food into the
stomach. The esophagus becomes dilated
because of food retention.
Esophageal Disease Cont…
Common complications associated with the
esophagus include:
Failure of the lower cardiac sphincter to correctly
function
Rips and tears of the lining associated with emesis
Esophageal obstructions which arise from
carcinoma, food blockages, or stricture
(scarring)
Gastritis
• Acute or chronic inflammation of the stomach is called gastritis. The
symptoms are pain and nausea.
• Acute gastritis is usually self limiting and is associated with drugs
like aspirin, ibuprofen, and other pain relievers. These nonsteroidal
anti-inflammatory drugs may inhibit the production of prostaglandins
that help protect the gastric mucosa which leads to gastritis and
ulceration. Excessive alcohol consumption may also cause acute
gastritis.
• Chronic gastritis is largely associated with the organism
Helicobacter pylori which colonize the gastric mucosa. The gastric
acid is neutralized by ammonia produced by the organism. Chronic
gastritis increases may lead to gastric carcinoma and malignant
lymphoma.
Peptic Ulcer
• A peptic ulcer is a chronic ulcer of the distal area of the
stomach or the proximal end of the duodenum. It is
associated with Helicobacter pylori colonization that
destroys the mucosa. The mucosa is perforated and
gastric acid and pepsin digest deeper tissue.
Scarring occurs at the base of the ulcer. Complications
of the condition include: hemorrhage, perforation of
associated organs, and obstruction. Antacids for
ulcers are recommended. Surgery may also be required.
Stomach Carcinoma
• The initial symptoms for this disease
mimic symptoms of a benign peptic ulcer.
Many times the disease is discovered too
late for successful treatment. To
differentiate stomach carcinoma from
other maladies, the physician may use
gastroscopy and biopsy. Surgical
resection of the affected areas is
recommended.
Inflammatory Disease of the
Intestine
• Enteritis is the inflammation of any area of the
intestinal tract.
• Colitis is inflammation of the colon.
• Acute enteritis is usually caused by pathogenic
organisms. Symptoms for this disease are
vomiting, nausea, discomfort, diarrhea, and
bloody stool.
• Chronic enteritis is associated with two major
conditions that are autoimmune diseases. These
are Crohn’s Disease and chronic ulcerative
colitis.
Appendicitis
• The appendix is a narrow vestigial structure from
the colon. It may become impacted with fecal
material and inflamed. Signs and symptoms of
an acute appendicitis attack include: right lower
quadrant abdominal pain, abdominal rigidity, and
increased neutrophils in the peripheral
circulation. Peritonitis may result which
complicates the patient’s chances for recovery.
Bowel Disturbances
These disturbances include: lactose and
gluten intolerances causing flatulence and
loose stools. Irritable bowel syndrome of
unknown etiology is a disease with
disturbed bowel function, abdominal
discomfort, and loud bowel gurgling.
Diverticulitis and Diverticulosis
• Outpouchings of the muscular wall of the large
intestine are called diverticulosis.
• Diverticula are observed in older patients with
low residue that cause damaging hard stools.
• Diverticula that become inflamed are called
diverticulitis. Diverticulitis may progress to
abscesses and ulceration. The condition may
become serious and require surgical resection.
Intestinal Obstruction
• Intestines, that are blocked, are considered to have
intestinal obstructions. Causes of intestinal obstruction
include: 1. intestinal adhesions of connective tissue or
loops of twisted bowel, 2. hernias or loops of bowel
pushed through intestine into areas of the scrotum
(inguinal hernia) or umbilical areas, 3. tumors, 4.
volvulus or twisting of bowel to constrict blood supply
and pulling the bowel from the wall of the abdomen. 5.
intussusceptions, in children is usually a telescoping of
the ileum into the colon through the ileocecal valve
Tumors of the Bowel
• Benign tumors of the colon called polyps
do not usually cause symptoms and can
be removed surgically with a colonoscope.
• Carcinomas or the colon may block the
colon and cause bowel obstruction
symptoms. These tumors may bleed and
lead to chronic iron-deficiency anemia
Hemorrhoids
• The condition in which swollen veins of the
venous plexus drain into the rectum and
anus is called a hemorrhoid. Hemorrhoids
are caused by constipation and
straining during bowel movements. They
may also appear during pregnancies.
Hemorrhoids may become thrombosed
and cause discomfort. Surgical removal of
hemorrhoids may be recommended.