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Disturbances of Gastrointestinal Function

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Thelmah S Kenalemang
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12 views

Disturbances of Gastrointestinal Function

Uploaded by

Thelmah S Kenalemang
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Disturbances of Gastrointestinal Function

Introduction
• Gastrointestinal disturbances affect the gastrointestinal (GI) tract from mouth to
anus. There are two types: functional and structural.
• Functional GI disturbances are a group of disorders characterised by GI symptoms
(abdominal pain, dysphagia, dyspepsia) in the absence of demonstrable pathology.
• The GI tract looks normal when examined but doesn’t move properly.
• They are the most common disorders affecting the GI tract.
• Common examples include diarrhoea, constipation, irritable bowel syndrome (IBS),
ulcerative colitis and celiac disease.
Many factors can upset the GI tract and its movements, including:
• Eating diet low in fiber
• Travelling or other changes in routine
• Eating large amounts of dairy products
Factors that can upset the GI tract
• Stress
• Resisting the urge to have a bowel movement, because of hemorrhoids.
• Overusing anti-diarrhoeal medications that, over time, weaken the bowel
muscle movements.
• Taking antacid medications containing calcium or aluminium
• Taking antidepressants, iron pills and strong pain medicines such as
narcotics.
• Pregnancy
• Some people also have heightened sensitivity in the organs of their GI tract
(visceral hypersensitivity). This can make them feel pain or discomfort.
Common functional GI conditions
Constipation
• Constipation makes it hard for an individual to have a bowel
movement (or pass stools), the stools are infrequent or incomplete.
• Constipation is often due to inadequate fiber in the diet
• It may cause small, hard stools and sometimes anal problems such as
fissures or hemorrhoids.
• It may be treated by increasing the amount of fiber and water in the
diet and exercising regularly. If these treatments don’t work, laxatives
can be useful.
Irritable bowel syndrome (IBS)
• IBS is a condition where the intestinal muscles contract more often than
“normal.” Certain foods, medicines and emotional stress are some factors
that can trigger IBS.
Symptoms of IBS include:
• Abdominal pain and cramps
• Excess gas
• Bloating
• Change in bowel habits such as harder, looser, or more urgent stools than
normal
• Constipation and/or diarrhoea
NB: IBS can be assessed by measuring the faecal concentration of the protein
calprotectin.
Irritable bowel syndrome (IBS)
IBS can be treated at home by:
• increasing fiber in the diet.
• monitoring which foods trigger IBS (and avoiding these foods).
• taking medicines as prescribed by the healthcare provider.
• avoiding dehydration and hydrating well throughout the day.
• getting high quality rest/sleep.
Colitis
There are several types of colitis, which are conditions that cause an
inflammation of the bowel. These include:
• Infectious colitis
• Ulcerative colitis (cause unknown)
• Crohn’s disease (cause unknown)
• Ischemic colitis (cause by not enough blood going to the colon)
• Radiation colitis (after radiotherapy)
Colitis can cause diarrhoea, rectal bleeding, abdominal cramps and
frequent & immediate need to empty the bowels. Treatment depends
on the diagnosis which is made by colonoscopy and biopsy.
Coeliac disease
• This condition, also known as gluten-sensitive enteropathy, is the commonest cause of
malabsorption.
• Malabsorption is caused by villous atrophy, affecting particularly the mucosa of the
proximal small intestine.
• Coeliac disease is a result of sensitivity to gliadin, a protein present in wheat and other
cereal flours.
• Complete withdrawal of gluten from the diet leads to regrowth of villi and eventual
resolution of symptoms.
• Diagnosis is by small intestine biopsy.
• Various antibodies (e.g. against gliadin and tissue transglutaminase) are present in
plasma in active disease.
• The detection of tissue transglutaminase antibody provides the most sensitive (85%) and
specific (97%) serological screening test for coeliac disease.
Structural GI diseases
• Structural GI diseases are where the bowel looks abnormal upon
examination and also doesn’t function properly.

• Sometimes the structural abnormality needs to be removed surgically

• Common examples of structural GI disease include anal fissures,


hemorrhoids, colon polyps, and colon cancer.
Colon polyps and cancer
• Almost all colorectal cancers begin as colon polyps, benign growths in the tissues
lining the colon and rectum.
• Cancer develops when these polyps grow, and abnormal cells develop and start
to invade surrounding tissues.
• Removal of polyps can prevent the development of colorectal cancer. Almost all
pre-cancerous polyps can be removed painlessly during a colonoscopy screening.
• By using a variety of screening tests, it is possible to prevent, detect and treat the
disease long before symptoms appear.
• When symptoms do occur, the cancer might already be quite advanced.
Symptoms include bloody stool, a change in normal bowel habits, abdominal
pain, weight loss, constant tiredness or anaemia.
Hemorrhoids
• Hemorrhoids are dilated veins in the anal canal. They are caused by chronic
excess pressure from straining during a bowel movement.
• There are two types: internal and external
• Internal hemorrhoids are blood vessels on the inside of the anal opening.
• They become irritated and start to bleed due to straining.
• Treatment includes: improving bowel habits, healthcare provider using ligating
bands to eliminate the vessels and removing them surgically.
• External hemorrhoids are veins that lie just under the skin on the outside of the
anus. Sometimes, after straining, the veins burst and blood clots form.
• Treatment includes removing the clot and vein under local anaesthesia and/or
removing the hemorrhoid itself.
Summary
• Many intestinal disease can be prevented or minimized by maintaining a healthy lifestyle,
practicing good bowel habits and getting screened for cancer.
• A colonoscopy is recommended for average-risk patients at age 45. If someone has a
family history of colorectal cancer or polyps, a colonoscopy may be recommended at a
younger age.
• Other functional and structural diseases include peptic ulcer disease, gastritis, and
gastroenteritis, appendicitis and pancreatitis.
• Inflammation in the upper GI tract, which is commonly caused by a bacteria called
Helicobacter pylori, can cause different types of ulcers.
• Endoscopy is a minimally invasive procedure in which a thin flexible tube with a lighted
camera on the end is inserted into the mouth or nose and used to examine parts of the
gastrointestinal (GI) tract including linings, tissues, and organs.
• It can identify polyps, lesions, pre-cancerous or cancerous cells, ulcers and other
abnormalities.

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