Gastrointestinal study guide
Common Non-Specific Presenting Symptoms:
Dyspepsia
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Nasusea and Vomiting
Pathophysiology
S/S
Tests
Treatments
Misc.
Dysphagia
Pathophysiology a. neurologic - stroke, lesion, MS, post-polio syndrome, Parkinson's etc.
b. muscular and rheumatologically - myopathies, sjogren's
c. Metabolic - thyrotoxicosis, amyloidosis, Cushings, medication side effects
d. Infectious - polio, DPT, botulism, Lyme, syphilis
e. Structural - Zenker's, webs, tumors, post surgical or radiation, pill-induced
S/S Painful or difficult swallowing
Tests
Treatments Treat underlying cause
Misc.
Constipation
Pathophysiology
S/S
Tests
Prevention
Treatments
Misc.
Acute Diarrhea
1
, Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc. *Review common infectious pathogens and their presentation.
Be sure to know inflammatory versus noninflammatory and how to distinguish
Chronic Diarrhea
Pathophysiology
Tests
Treatments
Abdominal Pain:
Quality Origin Example
Visceral Pain Vague, dull, Midline location due to bilateral Early appendicitis
poorly localized innervation of organs. Stretching,
inflammation, or ischemia of bowel
walls or organ capsules
Parietal Pain Sharp, well Inflammation, frank pus, blood, or bile Late appendicitis
localized adjacent to the peritoneum.
Referred Pain Pain felt at a Sites of common innervation, common LLQ rebound tenderness
sight distance to embryological origin w/ appendicitis
actual pathology
Gastrointestinal Bleeding-
Acute Upper GI Bleeding
Pathophysiology 1. Peptic Ulcer disease – almost ½ the cases
2. Portal HTN – varices
3. Mallory-Weiss tears – alcohol abuse or retching
4. Vascular anomalies (AVM)
5. Gastric neoplasms – only 1% of pts.
6. Erosive gastritis – rarely causes severe bleeding, more common chronic loss
7. Erosive esophagitis – GERD
S/S Hematemesis (bright red blood or coffee grounds), melena, hematochezia in massive
bleeds.
Epidemiology
Tests
Prevention
Treatments
Misc.
2
, Lower GI Bleeding (distal to the ligament of Treitz)
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Disorders of the Esophagus:
GERD
Pathophysiology
S/S
Epidemiology
Tests
Prevention .
Treatments
Misc.
Infectious Esophagitis
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Mallory-Weiss Tears (Mucosal Laceration of Gastroesophageal Junction)
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Esophageal Webs and Rings
3
Common Non-Specific Presenting Symptoms:
Dyspepsia
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Nasusea and Vomiting
Pathophysiology
S/S
Tests
Treatments
Misc.
Dysphagia
Pathophysiology a. neurologic - stroke, lesion, MS, post-polio syndrome, Parkinson's etc.
b. muscular and rheumatologically - myopathies, sjogren's
c. Metabolic - thyrotoxicosis, amyloidosis, Cushings, medication side effects
d. Infectious - polio, DPT, botulism, Lyme, syphilis
e. Structural - Zenker's, webs, tumors, post surgical or radiation, pill-induced
S/S Painful or difficult swallowing
Tests
Treatments Treat underlying cause
Misc.
Constipation
Pathophysiology
S/S
Tests
Prevention
Treatments
Misc.
Acute Diarrhea
1
, Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc. *Review common infectious pathogens and their presentation.
Be sure to know inflammatory versus noninflammatory and how to distinguish
Chronic Diarrhea
Pathophysiology
Tests
Treatments
Abdominal Pain:
Quality Origin Example
Visceral Pain Vague, dull, Midline location due to bilateral Early appendicitis
poorly localized innervation of organs. Stretching,
inflammation, or ischemia of bowel
walls or organ capsules
Parietal Pain Sharp, well Inflammation, frank pus, blood, or bile Late appendicitis
localized adjacent to the peritoneum.
Referred Pain Pain felt at a Sites of common innervation, common LLQ rebound tenderness
sight distance to embryological origin w/ appendicitis
actual pathology
Gastrointestinal Bleeding-
Acute Upper GI Bleeding
Pathophysiology 1. Peptic Ulcer disease – almost ½ the cases
2. Portal HTN – varices
3. Mallory-Weiss tears – alcohol abuse or retching
4. Vascular anomalies (AVM)
5. Gastric neoplasms – only 1% of pts.
6. Erosive gastritis – rarely causes severe bleeding, more common chronic loss
7. Erosive esophagitis – GERD
S/S Hematemesis (bright red blood or coffee grounds), melena, hematochezia in massive
bleeds.
Epidemiology
Tests
Prevention
Treatments
Misc.
2
, Lower GI Bleeding (distal to the ligament of Treitz)
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Disorders of the Esophagus:
GERD
Pathophysiology
S/S
Epidemiology
Tests
Prevention .
Treatments
Misc.
Infectious Esophagitis
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Mallory-Weiss Tears (Mucosal Laceration of Gastroesophageal Junction)
Pathophysiology
S/S
Epidemiology
Tests
Prevention
Treatments
Misc.
Esophageal Webs and Rings
3
