Lecture Notes on Gastrointestinal Disorders

Introduction

• Discussion on the gastrointestinal system focusing on:
  • Peptic Ulcer Disease (PUD)
  • Gastroesophageal Reflux Disease (GERD)
  • Hernias

Learning Objectives

• Understand the pathophysiology of discussed diseases.
• Relate this knowledge to patient care.
• Reflect on prior knowledge, experiences, and knowledge gaps.
• Active participation and reflection encouraged.

Peptic Ulcer Disease (PUD)

Pathophysiology

• Ulcers form in the stomach, duodenum, or esophagus.
• H. pylori infection is a major cause (80-95%).
• NSAIDs disrupt protective mucosal barriers.
• Duodenal ulcers: High acid secretion.
• Gastric ulcers: Normal/decreased acid production.

Risk Factors

• NSAID use, familial tendency, stress ulcers from severe physiological stress.
• Blood type O individuals are more susceptible.

Symptoms

• Gastric Ulcers: Pain post meals, weight loss, vomiting.
• Duodenal Ulcers: Pain relief with eating, potential weight gain.

Assessment

• Pain, distension, tenderness, bleeding signs.
• Lifestyle factors: smoking, NSAID use.
• Signs of anemia: fatigue, weakness, palpitations.

Diagnostics

• EGD, H. pylori testing (blood, stool, breath tests).
• CBC for blood loss evaluation.

Management

• Antibiotic cocktail, PPIs, lifestyle changes.
• Monitor for complications: hemorrhage, perforation, obstruction.

Nursing Care

• Patient education on lifestyle modifications.
• Monitor for complications like bleeding, perforation.

Gastroesophageal Reflux Disease (GERD)

Pathophysiology

• Backflow of gastric contents causing esophageal damage.
• Increased risk with age, IBS, tobacco use, H. pylori infection.

Symptoms

• Heartburn, dyspepsia, regurgitation, esophagitis.
• Potential mistaken for heart attack.

Assessment

• Patient history, endoscopy, barium swallow, pH monitoring.

Management

• Lifestyle changes: weight loss, avoiding triggers.
• Medical management: PPIs, H2 blockers.
• Surgical: Fundoplication for severe cases.

Nursing Care

• Dietary advice, managing reflux.
• Monitor for Barrett’s esophagus, aspiration risks.

Hiatal Hernias

Types

• Sliding Hernia: Stomach slides up through the diaphragm.
• Paraesophageal Hernia: Part of the stomach pushes through a separate diaphragm opening.

Manifestations

• Similar to GERD: heartburn, regurgitation.
• May be asymptomatic.

Diagnostics

• X-ray, barium swallow, EGD.

Management

• Dietary changes, surgery if symptomatic.

Nursing Care

• Monitor for reflux, aspiration potential.

Other Hernias

Types

• Abdominal wall hernias: epigastric, umbilical, inguinal, femoral.

Considerations

• Potential signs: pain, obstruction, strangulation.
• Reducible vs. irreducible hernias.

Conclusion

• Review and understand learning objectives.
• Engage in active learning and self-assessment.