Gastrointestinal Disorders

Gastrointestinal Disorders


Achalasia is a disease of the muscle of the esophagus. In achalasia, the lower esophageal sphincter (LES) “fails to relax” and open to allow food to pass into the stomach. As a result, patients with achalasia have difficulty swallowing food.


The exact cause is unknown, but theories include:

  • heredity

  • infection

  • autoimmune disease.


The most common major surgical disease, appendicitis, is inflammation and obstruction of the vermiform appendix. Since the advent of antibiotics, the incidence and the death rate of appendicitis have declined; if untreated, this disease is invariably fatal.


  • Mucosal ulceration

  • Fecal mass (fecalith)

  • Stricture

  • Barium ingestion

  • Viral infection

  • Neoplasm

  • Foreign body


Cholecystitis — acute or chronic inflammation causing painful distention of the gallbladder — is usually associated with a gallstone impacted in the cystic duct. Cholecystitis accounts for 10% to 25% of all gallbladder surgery. The acute form is most common among middle-aged women; the chronic form, among elderly people. The prognosis is good with treatment.


  • Gallstones (the most common cause)

  • Poor or absent blood flow to the gallbladder

  • Abnormal metabolism of cholesterol and bile salts


Cirrhosis is a chronic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. Mortality is high; many patients die within 5 years of onset. As cirrhosis progresses, complications may occur; these include ascites, portal hypertension, jaundice, coagulopathy, hepatic encephalopathy, bleeding, esophageal varices, acute GI bleeding, liver failure, and renal failure.


  • Hepatitis

  • Alcoholism

  • Malnutrition

  • Autoimmune disease, such as sarcoidosis or chronic inflammatory bowel disease

  • Diseases of the biliary tree

  • Sclerosing cholangitis

  • Wilson’s disease

  • Alpha1 antitrypsin deficiency

  • Hemochromatosis

  • Hepatic vein obstruction

  • Right-sided heart failure


A polyp is a small tumorlike growth that projects from a mucous membrane surface. Types of polyps include common polypoid adenomas, villous adenomas, hereditary polyposis, focal polypoid hyperplasia, and juvenile polyps (hamartomas). Most rectal polyps are benign; however, villous and hereditary polyps tend to become malignant. Indeed, a striking feature of familial polyposis is its strong association with rectosigmoid adenocarcinoma.



Predisposing Factors

  • Heredity

  • Age

  • Infection

  • High-fat diet

  • Sedentary lifestyle


Colorectal cancer is the second most common visceral malignant neoplasm in the United States and Europe. It tends to progress slowly and remains localized for a long time. Incidence is equally distributed between men and women. It’s potentially curable in about 90% of patients if early diagnosis allows resection before nodal involvement.



Risk Factors

  • Low-fiber, high-fat, high-calorie diet

  • Other diseases of the digestive tract

  • History of ulcerative colitis (average interval before onset of cancer 11 to 17 years) and Crohn’s disease

  • Familial polyposis (cancer usually develops by age 50)

  • Sedentary lifestyle and obesity

  • Smoking

  • Alcohol abuse

  • Diabetes

  • Growth hormone disorder

  • Radiation therapy or history of colorectal cancer or polyps

  • Family history of colorectal cancer


Crohn’s disease, also known as regional enteritis or granulomatous colitis, is inflammation of any part of the GI tract (usually the terminal ileum), extending through all layers of the intestinal wall. It may also involve regional lymph nodes and the mesentery.



Possible Contributing Conditions

  • Lymphatic obstruction

  • Allergies and immune disorders

  • Infection

  • Genetic predisposition


In diverticular disease, bulging pouches (diverticula) in the GI wall push the mucosal lining through the surrounding muscle. Although the most common site for diverticula is in the sigmoid colon, they may develop anywhere, from the proximal end of the pharynx to the anus. Common sites include the duodenum, near the pancreatic border or the ampulla of Vater, and the jejunum.

Diverticular disease of the stomach is rare and is usually a precursor of peptic or neoplastic disease. Diverticular disease of the ileum (Meckel’s diverticulum) is the most common congenital anomaly of the GI tract.

Diverticular disease has two clinical forms:

  • diverticulosis — diverticula present but asymptomatic

  • diverticulitis — inflamed diverticula; may cause potentially fatal obstruction, infection, or hemorrhage.


  • Exact cause unknown

  • Diminished colonic motility and increased intraluminal pressure

  • Low-fiber diet

  • Defects in colon wall strength


Esophageal cancer is usually fatal. This disease occurs worldwide, but incidence varies geographically. It’s most common in Japan, China, the Middle East, and parts of South Africa. Common sites of distant metastasis include the liver and lungs.



Predisposing Factors

  • Chronic irritation by heavy smoking and excessive use of alcohol

  • Stasis-induced inflammation as in achalasia or stricture

  • Nutritional deficiency

  • Diets high in nitrosamines

  • Previous head and neck tumors


Gastric carcinoma is common throughout the world and affects all races; however, mortality is highest in Japan, Iceland, Chile, and Austria. In the United States, the incidence has decreased by 50% during the past 25 years and the resulting death rate is one-third of what it was 30 years ago.


Unknown; commonly associated with atrophic gastritis

Predisposing Factors

  • Tobacco smoke

  • Asbestos exposure

  • High alcohol intake

  • Intake of smoked, pickled, or salt-preserved foods, nitrates, and red meat

  • Type A blood

  • Helicobacter pylori infection (distal gastric cancer)

  • Family history of gastric cancer

  • Pernicious anemia

Sep 22, 2018 | Posted by in ANATOMY | Comments Off on Gastrointestinal Disorders
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