PATHOPHYSIOLOGY OF GASTRITIS

GASTRITIS
*Inflammation of gastric mucosa
mucosamucosa

ACUTE
*Last for several
hours/few days

CHRONIC
* Repeated exposure to
irritating agents & recurring
episodes of acute gastritis

PRECIPITATING FACTORS
Local irritants:
bacterial endotoxins (ex: Staph.,
E.coli, Salmonella & viruses),
overuse of Aspirin & other
NSAIDS, excessive alcohol intake
Acute illnesses/traumatic injuries:
- Burns
- Severe infection
- Hepatic/renal failure
- Respiratory failure
- Major surgery
Dietary indiscrition:
- Irritating foods
- Spicy foods
- Too highly seasoned




PREDISPOSING FACTORS
Autoimmune dse:
pernicious anemia
Peptic ulcer dse
Person who had
gastroduodenostomy/
gastrojejunostomy
surgery
PRECIPITATING FACTORS
Benign/malignant ulcers
of stomach
Helicobacter pylori
Dietary factors:
- Caffeine
- NSAIDS/bisphosphonate
- Alcohol
- Smoking
Chronic reflux of
pancreatic secretions of
bile into the stomach

S/Sx:
- Abdominal discomfort
- Headache
- Hiccupping
- Bleeding & hematemesis
- N/V
- Anorexia
- Heart burn after eating
- Sour taste in mouth
- Pernicious anemia
- Peptic ulcer

PATHOPHYSIOLOGY OF PEPTIC ULCER

















PEPTIC ULCER
Group of ulcerative disorders in Upper GI tract
that are exposed to acid pepsin secretions

secretion of HCl by gastric mucosa
or tissues resistance to acid.
Erosion of circumscribed area
PRECIPITATING FACTORS:
Helicobacter pylori
Zollinger-Ellison Syndrome
Aspirin/NSAIDS/indomethacin
PREDISPOSING FACTORS:
Early Adulthood (Gastric)
Older age (55-70 yrs.old)
(Duodenal)
Affect men 4x than women
S/Sx:
- Burning, gnawing, or
cramplike
- Superficial/ deep
epigastric tenderness &
voluntary muscle
guarding
- Hemorrhage,obstruction,
perforation
DUODENAL
ULCER
GASTRIC
ULCER
PATHOPHYSIOLOGY OF GASTRIC CANCER

GASTRIC CANCER
*cancer develops from the lining of the stomach
PRECIPITATING FACTORS:
Diet: carcinogenic factors:
salted, smoked, preserved
foods
Chronic inflammation of
stomach
H. pylori infection
Smoking
Achlorhydria
Gastric ulcers
Previous subtotal
gastrectomy (>20 yrs ago)
PREDISPOSING FACTORS:
Typical: 40-70 y.o/ <40 y.o
Men (higher incidence)
Native, Hispanic, African
Americans
Japanese (common)
Pernicious anemia
genetics
S/Sx:
Pain
Dyspepsia
Abdominal pain above umbilicus
Weight loss
Loss of appetite
Bloating after meals
N/V
Heartburn
Indigestion
Blood in stool
Anorexia
Mostly adenocarcinomas can occur anywhere in the stomach

Tumor infiltrates the surrounding mucosa
Penetrate the wall of stomach and adjacent & structures
LIVER PANCREAS
SSAS
ESOPHAGUS DUODENUM
Metastasis through lymph to the peritoneal cavity
PATHOPHYSIOLOGY OF DUODENAL TUMORS

DUODENAL TUMORS
*cancer cell in stomach that continue to form new abnormal cells called Tumors
PRECIPITATING FACTORS:
High fat diet
Smoking
Alcohol abuse
PREDISPOSING FACTORS:
Familial adenomatous polyposis
Celiac disease
Peutz-jeghers syndrome
Chrons disease
juvenile polyposis syndrome ( commonly
seen in children/adolescent
Men (common incidence)
Typical: 60 - above


S/Sx:
Abdominal pain & cramps
Weight loss
Weakness & fatigue
Anemia
Intestinal blockage
Blood in stool
GERD
Indigestion
N/V
Bloating

PATHOPHYSIOLOGY OF MORBID OBESITY

MORBID OBESITY
*excessive adipose accumulation
Circulatory Blood Volume
LV Stroke
Volume

Cardiac Output
LV Enlargement
LV Wall Stress
LV Hypertrophy
Inadequate Adequate
LV Systolic Dysfunction
LV Diastolic Dysfunction
Pulmonary Venous
Hypertension
Pulmonary Arterial
Hypertension
Hypoxia/Acidosis
s
Sleep Apnea/ Obesity
Hypoventilation
Syndrome
PRECIPITATING FACTORS:
Excessive alcohol intake
Thyroid disorder
Lack of physical activities
Other S/Sx:
Wt. gain
BMI >20
RV Hypertrophy
& Enlargement
RV FAILURE
LV FAILURE