,
,Gastrointestinal pathologies:
• Pathophysiology of GERD
Stomach acid or bile flows into the esophagus, leading to esophagitis
Caused by abnormalities in the lower esophageal sphincter function,
esophageal motility or gastric emptying
o Lower esophageal sphincter function: one way valve that
keeps contents from coming up into the esophagus, but
decreased tone allows regurgitation of stomach contents
o Esophageal motility: disrupt the coordinated
contractions that propel food down to the stomach. Can
cause delayed gastric emptying
o Delayed gastric emptying: contributes to
esophagitis by extending the period during which
reflux can occur and increasing the acid content of
chyme
• Signs and symptoms of GERD
o Typical: heartburn (pyrosis), regurgitation
o Atypical: chronic cough, asthma exacerbations,
laryngitis, sinusitis, hoarseness
o Associated symptoms: upper abdominal pain, dysphagia
(difficulty swallowing), belching, flatulence, sleep
disturbances, worsening of symptoms when lying supine
• Pharmacologic management of GERD
o PPI: omeprazole, esomeprazole, lansoprazole,
pantoprazole, rabeprazole
• Risk factors for esophageal stricture
o GERD, esophagitis, ingestion of causative agents, radiation
• Hiatal hernia treatment
o Lifestyle modifications, conservative treatment (eating
small frequent meals), medications (antacids, H2
receptor blockers, PPIs, prokinetic agents), surgery
(hernia repair)
• Pathophysiology of appendicitis
, o Inflammation of the appendix, occurs when the appendix
becomes obstructed by fecal matter, foreign bodies, or
swollen lymphoid tissue
• Symptoms of appendicitis
o Abdominal pain, nausea and vomiting, loss of appetite,
fever, rebound tenderness, guarding