selected gastrointestinal disorders so these are some very common disorders that you might see when you're in the acute care setting so it's really good that you have a good idea of these particular disorders their patho and then the normal treatment for these because you're going to see this again pretty frequently on the floors so heliobacter pylori or h pylori is typically how you're going to see that as said or as denoted in a chart okay the pathophysiology so this is a bacteria that enters your body and it lives in your digestive tract over years it can actually cause duodenal or gastric ulcers so pud that's peptic ulcer disease and gastritis so this bacterium secretes substances that break down mucosa gel and also appears to stimulate acid production in the stomach so smoking inhibits bicarbonate secretion so that's something to remember for patients who are smoking right because we need bicarbonate as an acid-base buffer so if someone is smoking um it's going to inhibit that bicarbonate secretion in their stomach which is going to further worsen someone who has h pylori it'll exacerbate that so treatment modalities what do we do for that typically patients are put on ppis they can be put on a meprazole or prilosec is the trade and then typically two antibiotics are often prescribed to treat the age pylori gastroesophageal reflux disease or gerd so this kind of is more elaborate some of the disease processes that were very briefly talked about when we were going over the classes of drugs okay so the pathophysiology this is a backward movement of gastric contents into the esophagus it's a reflux backward movement okay so when the reflux of gastric contents uh occurs it causes inflammation it can cause tissue damage to the esophagus it's known as gerd gerd so causative factors it can be a problem with the esophageal sphincter not functioning effectively where maybe gastric emptying is delayed for whatever reason and so that gastric content refluxes or backs up into that lower esophagus so contributing factors to this are increased volume um within the stomach after meals so if we ate a ginormous meal right more than we probably should have positioning so sometimes the patient may feel if they're going to lay flat right or they're going to bend over they can feel that reflux occur and then increased gastric pressure due to obesity or even restrictive clothing really tight clothing so how do we treat that treatment modalities we manage it with a combination of lifestyle changes and medication so we can use h2 receptor blockers and ppis those are often ordered to help suppress acid secretion in the stomach and then also to promote that esophageal healing irritable bowel syndrome pathophysiology this is a motility disorder it's characterized by alternating periods of constipation and diarrhea so intestinal motility can be affected by eating by stress hormones and drugs so this is not so much as a disease but it is a motility disorder of the gi tract so how do we treatment how do we treat it treatment modalities would be management is basically directed toward relieving the symptoms reducing or eliminating those precipitating factors we can provide the patient regular bulk forming laxatives that can help reduce bowel spasms and maybe help re-establish normal pattern of elimination and then we can also use ssris which you're going to learn about very soon this is selective serotonin reuptake inhibitors so we can use those uh ssris such as sertraline or zoloft you've probably heard the name zoloft before and fluoxetine fluoxetine is a generic name for prozac that can actually help relieve abdominal pain and spasms and then our last one here is crohn's disease so with crohn's disease the patho this is a very chronic relapsing inflammatory disorder that can affect part of the gi tract from the stomach or sorry part of the gi tract from the mouth to the anus is when is where this actually occurs so the distal portion of the small intestine and ascending colon are most commonly the areas that are affected crohn's disease can actually cause inflammatory lesions of the bowel mucosa that are basically affect all layers of the bowel wall so ulcers and deep fissures that develop those will actually occur and then fistulas can actually form between the loops of the bowel or even in between the bowel and other organs malabsorption and malnutrition also could develop and this can cause inflammation in ulcers and when the patient has this inflammatory process and ulcers happen it can actually prevent the absorption of nutrients especially vitamin b12 bile salts so most patients experience either continuous or even episodic diarrhea so stools generally will look liquid maybe even semi-formed typically they don't contain blood though so treatment modalities um the patient generally will be put on maybe some nsaids maybe corticosteroids detect you know the ideas that we're decreasing the inflammatory process they can even be put on immunosuppressive drugs and vitamins and antibiotics