Digestive System Disorders: Symptoms and Causes

Posted on Mar 28, 2025 in Nursing

Esophageal Conditions

Mallory-Weiss Syndrome

Also known as gastroesophageal laceration syndrome. This condition involves laceration and hemorrhage, often related to alcohol and aspirin intake.

Grade IV Esophageal Ulcers

Severe ulceration within the esophagus.

Gastritis: Stomach Lining Inflammation

Gastritis is the inflammation of the gastric mucosa (stomach lining). Inflammatory lesions are often regarded as non-specific dyspepsia or non-ulcerative dyspepsia.

Acute Gastritis

Diagnosis is typically made through endoscopy and biopsy, especially if premalignant lesions are suspected.

Chronic Gastritis

There are two main types:

  • Type A: Less frequent. Affects the body and fundus of the stomach. May be associated with pernicious anemia. Etiology can involve immunological disorders.
  • Type B: More common. Affects the antrum in younger patients but often affects the entire mucosa in elderly patients. No antibodies are typically present. Helicobacter pylori (H. pylori) infection is a common association.

Diagnosis for chronic gastritis is based on endoscopy and biopsy.

Specific Types of Gastritis

  • Ménétrier’s Disease (Hyperplastic Gastritis): Characterized by the presence of thick, large folds in the gastric mucosa.
  • Granulomatous Gastritis: Presence of granulomas in the gastric mucosa; may appear alongside other illnesses.
  • Eosinophilic Gastritis: Presence of eosinophil infiltrates in the gastric mucosa, often as part of eosinophilic gastroenteritis affecting the stomach.
  • Lymphoid Hyperplasia: Presence of gastric mucosal lymphoid tissue, sometimes appearing secondary to leukemic processes.
  • Infective Gastritis: Stomach involvement in a general infectious process, potentially taking the form of severe phlegmonous gastritis.

Note: Helicobacter pylori infection is a major cause of chronic gastritis, particularly Type B.

Gastrointestinal (GI) Bleeding

  • Upper GI Bleeding (UGIB / HDA): Originates proximal to the Ligament of Treitz (up to the 3rd portion of the duodenum).
  • Lower GI Bleeding (LGIB / HDB): Originates distal to the Ligament of Treitz (from the 4th portion of the duodenum onwards).

Signs of GI Bleeding

  • Hematemesis: Vomiting blood from the digestive tract.
  • Melena: Shiny, black, tar-like, paste-like stools, indicating the presence of at least 50 ml of blood that has been digested.
  • Hematochezia: Passage of fresh, red blood (not fully digested) through the anus, either alone or mixed with stool.

Appendicitis

Inflammation of the appendix. Its main complication is appendiceal perforation (occurring in ~20% of cases), which can cause localized peritonitis or a peritoneal abscess.

Clinical Presentation: Characterized by abdominal pain, initially located in the epigastrium and later migrating to the right iliac fossa. Associated symptoms may include ileus (bowel paralysis) and leukocytosis (high white blood cell count) with a left shift.

Intestinal Obstruction

Blockage preventing the normal flow of intestinal contents.

Causes of Mechanical Obstruction

  • Fecal impaction
  • Peritoneal adhesions (scar tissue)
  • Tumors
  • Strangulated hernia
  • Intussusception: Prolapse of one bowel segment into the lumen of another.
  • Intestinal stenosis secondary to inflammatory bowel disease.
  • Biliary ileus: Intestinal obstruction caused by the migration of a gallstone through the intestinal lumen.

Crohn’s Disease

A chronic inflammatory disease of unknown cause that can affect the ileum, colon, or both structures. Treatment may involve surgical resection of the affected segment (enterectomy).

Hemorrhoid Grading

Classification based on prolapse:

  • Grade I: No prolapse. Internal bleeding may occur.
  • Grade II: Protrusion during defecation, reduces spontaneously.
  • Grade III: Protrusion requires manual reduction.
  • Grade IV: Permanently prolapsed, cannot be manually reduced.

Intestinal Infections

  • Cholera: Acute bacterial infection of the small intestine (Vibrio cholerae), characterized by intense vomiting and profuse, watery diarrhea (“rice water” stools).
  • Salmonella: Bacterial infection (Salmonella species) often acquired through ingestion of contaminated food (e.g., eggs, poultry).
  • Shigellosis (Bacillary Dysentery): Bacterial infection of the intestine (Shigella species) characterized by bloody diarrhea.
  • Amebiasis: Intestinal and potentially liver infection caused by the protozoan Entamoeba histolytica, acquired through ingestion of food or water contaminated by infected feces.

Hepatitis and Liver Function

Hepatotropic Viruses

Viruses that primarily infect and settle in the liver.

Chronic Hepatitis

Characterized by the presence of inflammatory changes in liver hepatocellular structures lasting more than 6 months.

Antibody Response

  • IgM (Immunoglobulin M): The first antibody to appear in response to an antigen during an immune reaction.
  • IgG (Immunoglobulin G): Produced after the acute phase of the immune response, typically following the IgM response, providing longer-term immunity.