Pathophysiology & Causes
What causes peptic ulcer disease?
Erosion of the stomach or duodenal lining by gastric acid
Often initiated by H. pylori infection
What signs/symptoms may indicate diverticulitis?
Blood in stool
Abdominal pain (often lower left quadrant)
Diarrhea or constipation
Fever, nausea, vomiting
What is the gold standard imaging test for bowel obstruction?
CT scan with contrast
What treatment might you anticipate for a bowel obstruction?
Nasogatric tube placement for decompression
Bowel rest
Potential surgery
The condition of having diverticula in the colon
What is diverticulosis?
What is diverticulitis?
Out-pouchings of the colon (diverticulum) become inflamed
What are some signs and symptoms of a bowel obstruction?
Abdominal pain
Abdominal distention
Inability to pass stool/gas (some liquid stool may pass)
Vomiting - may smell like stool
How is peptic ulcer disease diagnosed?
EGD (esophagogastroduodenoscopy)
Biopsy for H. pylori presence
What is important to avoid when appendicitis is suspected?
Applying heat or excessive palpation of the abdomen due to risk for rupture
The first section of the small intestine, immediately beyond the stomach, leading to the jejunum.
What is a bowel obstruction?
Mechanical or nonmechanical blockage of intestines
Mechanical - Adhesions, tumors, hernias, strictures, foreign object ingestion, volvulus (twisting)
Nonmechanical - Ileus
What are the classic signs of appendicitis?
Right lower quadrant pain
Fever
Rebound tenderness
What lab value might suggest a complication of bowel obstruction is occuring?
Lactic acid elevation
What are some treatments for peptic ulcer disease?
PPIs
H2 receptor agonists
Antibiotics (H. pylori)
Avoiding NSAIDs
A type of bowel obstruction caused by twisting of the intestines.
What is a volvulus?
What is appendicitis?
Something obstructs the opening the appendix (fecaliths, tumors, parasitic infections)
Increases pressure inside the appendix and occludes blood vessels
In bowel obstruction, what kind of bowel sounds might you hear?
Hyperactive during early stages, absent late stages
How is diverticulitis diagnosed?
CT scan of abdomen with contrast
Colonoscopy in diverticulosis; should not be used in diverticulitis d/t perforation risk
A patient with diverticulitis should avoid these foods during acute flare ups
Nuts, seeds, fiber-rich foods
Clients with chronic GERD whose esophagus is exposed to acidic stomach content and causes changes in the squamous epithelial cells that line the esophagus and transition into columnar epithelium
What is Barrett's esophagus?
What are risk factors for peptic ulcer disease?
Obesity
NSAID use
Helicobacter pylori infection
What are some contrasting symptoms in gastric ulcers vs duodenal ulcers?
Gastric ulcers - Pain soon after consuming a meal
Duodenal ulcers - Pain 2-3 hours after consuming a meal
How is appendicitis diagnosed?
Abdominal CT scan
Ultrasound
CBC for elevated WBC count
CRP elevation r/t inflammation
What is a potential major complication of bowel obstruction, appendicitis, and diverticulitis?
Sepsis
A diagnostic test that uses a scope to examine the lining of the esophagus, stomach, and first part of the small intestine.
What is an esophagogastroduodenoscopy (EGD)?