GR 15 C Pathology of the Digestive System

Celiac sprue A chronic condition in which wheat glutens cause damage to the mucosa of the small intestine creating a malabsorption situation. Malabsorption, diarrhea, weight loss, flatulence, distended abdomen, anemia, back pain, hypoproteinemia, and impotence Patient history and physical exam, radiologic studies, intestinal biopsy, blood studies for specific antibodies Gluten free diet, anti- inflammatory medication Affects 100/200 Americans

Cholelithiasis Inflammation of the gallbladder. Formation or presence of stones or calculi in the gallbladder or common bile duct. Asymptomatic/ mild discomfort to extreme pain often preceded with ingestion of fatty or greasy foods Physical exam/ patient history, radiologic studies, ultrasound, oral cholecystography, cholescintigraphy, blood work Changes in diet, observation, surgical removal if deemed severe

Cholecystitis An acute or chronic inflammation due to gallstones (cholelithiasis) blocking ducts in the gallbladder Sudden / severe pain, fever, nausea, vomiting, tenderness in the right upper quadrant of the abdomen Patient history / physical exam, imaging studies Avoid fatty foods. Surgical removal

Cirrhosis Chronic inflammatory disease of the liver, leading to irreversible scarring and destruction of active liver tissue. Enlargement of the liver with nausea / vomiting, weakness, jaundice, swollen ankles, loss of weight, loss of body hair, massive hematemesis, coma, and sometimes death Patient exam and history, blood results Cessation of causative agent

Crohn’s disease Form of chronic inflammatory bowel disease affecting the ileum and/or colon. Pain, cramps, diarrhea, bloating, weight loss Physical exam and history, radiologic studies Anti- inflammatory medications

Diverticulitis Infection and inflammation of a diverticulum or sac in the intestinal tract, especially in the colon Bleeding, abdominal pain, fever, hyperactive bowel sounds, inflammation, abcess Patient history and physical, blood work, x-rays, endoscopy High fiber diet, stool softeners, antibiotics, surgery

Gastroesophageal Reflux Disease (GERD) Erosion of the esophageal lining due to acid reflux Heartburn especially following a meal, often during recumbence Patient history, examination, gastroscopy, barium studies Treat causative agents, medications such as antacids and those reducing stomach acid production

Gastroenteritis Infection and/or inflammation of the stomach and small intestine due to a virus or bacterium. Abdominal pain, nausea, vomiting, diarrhea. Patient history, imaging studies, identification of offending agent Antibiotics (if bacterial infection), antiemetics, antidiarrheal drugs

Hemorrhoids Varicose veins in the rectum Pain, itching / burning sensation, bleeding Proctoscopy, stool sample examination Dietary changes (more fiber / water), stool softeners, medication to relieve discomfort

Hepatitis Viral Hepatitis Caused by a virus. Several types of hepatitis (A [food or water-borne], B [blood-borne or sexually transmitted], C, D, and E) Jaundice, fever, nausea, anorexia, weakness, arthralgia, enlarged and tender liver, and dark urine. Patient history and physical examination, blood work, liver biopsy, stool samples, immunodiagnostics Preventative vaccine (for hepatitis type B), preventative practices, immunoglobulin injections, and antiviral drugs Hep B HEP A

Hernia Hernia or out- pouching of intestines Visual bulging, pain, discomfort, adhesions, strangulation History and examReduced, binding, surgery

Irritable bowel syndrome (IBS) Disturbance in the functions of the intestine from unknown causes. Symptoms generally include abdominal discomfort/pain, bloating, and an alteration in bowel activity (diarrhea, constipation) Patient exam and history, radiologic studies, stool sample examination Lifestyle alterations, dietary considerations, Medication

Peptic ulcer Ulcer occurring in the lower portion of the esophagus, stomach, and duodenum caused by the breakdown of the mucosal membrane by the acid of gastric juices and pepsin. Heartburn, indigestion, sharp localized pain, often relieved by eating only to return again within hours, possible back pain, possible diarrhea, bleeding a possibility Patient history and examination, barium/radiologic studies, biopsy Remove causative agent(s), reduce stress, utilize medications such as antacids/ antibiotics, or H2 blockers (drugs) that block release of histamine, surgery only in extreme cases

Ulcerative Colitis Ulceration of the mucous membranes of the colon, Inflammation of the region, lesions, fever, abdominal pain, diarrhea, weight loss, Patient history, radiographic studies, endoscopic studies, blood work Surgical intervention, anti-inflammatories

Fecal testing Looks at consistency, color, odor, pH, shape, size – Pasty-high fat – Bulky and frothy-celiac – Diarrhea or constipation Presence of blood, bacteria, food residue, mucus, parasites, pus, tissue particles

Colonoscopy