Term
heartburn
abdominal pain
dyspepsia - upset stomach
nausea
vomiting
diarrhea
constipation
gastrointestinal bleeding - melena (upper GI bleed, dark/tarry stools); hematochezia (lower GI bleed)
itching - symptom of hepatobiliary disease, itching of palms of hands and/or soles of feet |
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Definition
| common symptoms associated with GI disorders |
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Term
patient history is the cornerstone of GI evaluation
should be detailed and chronological
use OLDCARTS during interview
discuss dietary habits
weight changes
travel outside of US
family history of GI disorders
medication history |
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Definition
| patient history that should be obtained when interviewing about GI disorders |
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Term
injury to GI mucosa:
ASA/NSAIDs
bisphosphonates
corticosteroids
alcohol
warfarin (no injury to GI mucosa, but it injured patient is more likely to bleed)
chemotherapy
iron
cause liver damage:
APAP
amiodarone
statins
methyldopa
PTU
interferon beta
duloxetine
diarrhea, GI symptoms:
antibiotics |
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Definition
| medications that may cause GI injury |
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Term
assess organ function
screen for certain GI disorders
evaluate effectiveness of therapy |
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Definition
| reasons for lab testing in GI disorders |
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Term
CBC:
WBC - infection, malignancy
Hgb/Hct - possible blood loss, anemias
PLT - risk of bleeding, malignancy, liver disease
serum chemistry panel (BMP, Chem 7):
BUN and SCr - hypdration status, renal function
Na, Cl, K - electrolyte abnormalities from diarrheal illnessess
liver function tests (LFTs):
PTT and INR (clotting factors made in the liver)- hepatic disease
albumin - hepatic or renal disease
alkaline phosphatase and bilirubin - hepatobiliary disease
measure of liver damage:
ALT and AST (byproduct of cell damage) - liver disease (end stage liver disease, these may be low b/c the liver is so damaged that ALT/AST cannot be produced any more)
amylase and lipase - pancreatic illness
microbiology - stool studies for infectious diarrhea or H. pylori infection |
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Definition
| lab testing for GI disorders |
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Term
plain x-ray: bowel obstruction and perforation
x-ray with contrast:
barium sulfate usually used - unabsorbably; constipation most common ADR
used to identify mucosal lesions, hiatal hernias, strictures, polyps, tumors, ulcers |
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Definition
| use of an x-ray in evaluating GI disorders |
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Term
upper GI series: radiographic visualization of the esophagus, stomach, small intestine
observe swallowing of contrast agent - esophageal structure and function
small bowel follow-through - gastric cancer, PUD, esophagitis, gastric outlet obstruction, Crohn's disease
low sensitivity and sepcificity
PATIENT EDUCATION: no eating/drinking 8-12 hours prior to test |
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Definition
| use of an upper GI series in evaluating GI disorders, patient education |
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Term
lower GI series: radiographic visualization of the colon and rectum
barium enema given during procedure
detects obstructions and lesions
diagnosis of Crohn's disease, ulcerative colitis, colon cancers, and diverticulitis
PATIENT EDUCATION: no eating/drinking 8-12 hours prior to test; bowel cleansing agents administered prior to test |
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Definition
| use of a lower GI series in evaluating GI disorders, patient education |
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Term
ultrasonography can be used to visualize the gallbladder, liver, pancreas, abdominal wall
differences in reflection of sound waves
can identify gallstones, hepatobiliary and pancreatic diseases
limited by bowel gas and excessive body fat |
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Definition
| use of ultrasonography in evaluating GI disorders |
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Term
transverse planes of tissue by radiographic beam and computer analysis produces a precise reconstructed image
contrast agents may be used
detects disease of liver, pancreas, spleen, colon (liver cancer, pancreatitis, pancreatic cancer, abscesses, cysts)
PATIENT EDUCATION:
no eating/drinking x4h before
have to drink a lot of water after administration of IV contrast agents to avoid kidney damage
metformin:
patients should stop taking metformin the day of the procedure and 48 hours afterward
get a baseline SCr and a SCr 48h after administration of IV contrast to evaluate renal status |
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Definition
| use of computed tomography (CT) or computed axial tomography (CAT) in evaluating GI disorders, patient education |
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Term
radiofrequency signals forming a 2-dimensional image
greatest sensitivity for liver tumors |
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Definition
| use of magnetic resonance imaging (MRI) in the evaluation of GI disorders |
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Term
illuminated optical instrument to inspect the interior of GI tract
inspect intraluminal mucosal lesions and obtain biopsies and washings for cytology studies
common indications: evaluating suspected GI bleed, obstructions, upper abdominal pain, infections (C. difficile colitis), malignancies, colonic lesions, colonic polyps
"conscious sedation" used for procedures
contraindicated for patients w/ severe respiratory distress or cardiac failure
many types:
esophagogastroduodenoscopy (EGD) - visualizes upper GI tract up to the duodenum
colonoscopy
sigmoidoscopy
endoscopic retrograde cholangiopancreatography (ERCP) - inspect pancreas if gallstones as suspected
capsule endoscopy - patient swallows a capsule that has a camera in it
PATIENT EDUCATION:
no eating/drinking x8-12h prior
bowel prep and cleansing prior to colonoscopy or sigmoidoscopy |
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Definition
| use of an endoscopy for evaluation of GI disorders, patient education |
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Term
ultrasonography
computed tomography (CT) or computed axial tomography (CAT)
magnetic resonance imaging (MRI)
endoscopy |
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Definition
| examples of imaging studies to evaluate the GI tract |
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Term
plain x-ray
x-ray with contrast
upper GI series
lower GI series |
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Definition
| examples of radiology used to study the GI tract |
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