Digestive System:

Digestive diseases are disorders of the digestive tract, which is sometimes called the
gastrointestinal (GI) tract.
In digestion, food and drink are broken down into small parts (called nutrients) that the body can
absorb and use as energy and building blocks for cells.
The digestive tract is made up of the esophagus (food tube), stomach, large and small intestines,
liver, pancreas, and the gallbladder.

Clinical findings:

The first sign of problems in the digestive tract often includes one or more of the following
symptoms:
 Bleeding
 Bloating
 Constipation
 Diarrhea
 Heartburn
 Incontinence
 Nausea and vomiting
 Pain in the belly
 Swallowing problems
 Weight gain or loss
A digestive disease is any health problem that occurs in the digestive tract. Conditions may range
from mild to serious. Some common problems include heartburn, cancer, irritable bowel
syndrome, and lactose intolerance.
Other digestive diseases include:
 Gallstones, cholecystitis, and cholangitis
 Rectal problems, such as anal fissure, hemorrhoids, proctitis, and rectal prolapse
 Esophagus problems, such as stricture (narrowing) and achalasia and esophagitis
 Stomach problems, including gastritis, gastric ulcers usually caused by Helicobacter
pylori infection and cancer
 Liver problems, such as hepatitis B or hepatitis C, cirrhosis, liver failure, and autoimmune
and alcoholic hepatitis
 Pancreatitis and pancreatic pseudocyst
 Intestinal problems, such as polyps and cancer, infections, celiac disease, Crohn
disease, ulcerative colitis, diverticulitis, malabsorption, short bowel syndrome, and intestinal
ischemia
 Gastroesophageal reflux disease (GERD), peptic ulcer disease, and hiatal hernia

Diagnosis:

Tests for digestive problems can include colonoscopy, upper GI endoscopy, capsule endoscopy,
endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound.
Many surgical procedures are performed on the digestive tract. These include procedures done
using endoscopy, laparoscopy, and open surgery. Organ transplants can be performed on the
liver, pancreas, and small intestine.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a

chronic upper gastrointestinal disease in which stomach content persistently and regularly flows
up into the esophagus, resulting in symptoms and/or complications.[6][7][10] Symptoms include
dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain,
extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or
asthma.[10] In the long term, and when not treated, complications such as esophagitis, esophageal
stricture, and Barrett's esophagus may arise.[6]

Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications.
Medications that may cause or worsen the disease include benzodiazepines, calcium channel
blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to
poor closure of the lower esophageal sphincter, which is at the junction between the stomach and
the esophagus. Diagnosis among those who do not improve with simpler measures may
involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.[6]

Treatment options include lifestyle changes, medications, and sometimes surgery for those who
do not improve with the first two measures. Lifestyle changes include not lying down for three
hours after eating, lying down on the left side, raising the pillow or bedhead height, losing
weight, and stopping smoking.[6][11] Foods that may precipitate GERD symptoms include coffee,
alcohol, chocolate, fatty foods, acidic foods, and spicy foods.[12] Medications
include antacids, H2 receptor blockers, proton pump inhibitors, and prokinetics.

Overview

Peptic ulcers are open sores that develop on the inside lining
of your stomach and the upper portion of your small
intestine. The most common symptom of a peptic ulcer is
stomach pain.
Peptic ulcers include:

 Gastric ulcers that occur on the inside of the stomach

 Duodenal ulcers that occur on the inside of the upper portion of your small intestine
(duodenum)
The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori
(H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stress and spicy foods do not
cause peptic ulcers. However, they can make your symptoms worse.

Symptoms

 Burning stomach pain

 Feeling of fullness, bloating or belching
 Intolerance to fatty foods
 Heartburn
 Nausea
The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain
worse, as does having an empty stomach. The pain can often be relieved by eating certain foods
that buffer stomach acid or by taking an acid-reducing medication, but then it may come back.
The pain may be worse between meals and at night.

Many people with peptic ulcers don't even have symptoms.

Less often, ulcers may cause severe signs or symptoms such as:

 Vomiting or vomiting blood — which may appear red or black

 Dark blood in stools, or stools that are black or tarry
 Trouble breathing
 Feeling faint
 Nausea or vomiting
 Unexplained weight loss
 Appetite changes

Appendicitis is an inflamed appendix. It can cause acute (sudden, intense) pain in your
lower abdomen. Your appendix is a small, tubular pouch, about the size of a finger, that
protrudes from the lower right end of your large intestine. Poop (feces) moving through
your large intestine can block or infect your appendix, leading to
inflammation. Inflammation causes your appendix to swell, and when it swells, it can
burst.

A burst appendix is a medical emergency. It spreads bacteria from inside your bowels
throughout your abdominal cavity. This infection (peritonitis) can then spread to your
bloodstream, which can lead to life-threatening complications (sepsis). Because of this
risk, the standard treatment for appendicitis is to remove your appendix
(appendectomy). Your appendix isn’t an essential organ, and you won’t miss it.

What is acute appendicitis vs. chronic appendicitis?

Appendicitis is almost always an acute condition, which means it begins suddenly and
worsens quickly. Most of what we know about appendicitis refers to acute appendicitis,
which is very common. Chronic appendicitis is a rare condition that we don’t know as
much about. It appears to occur when something irritates your appendix in an on-and-
off sort of way over a long period, but it never gets worse.

What Is Appendicitis?
Appendicitis is an inflammation of the appendix. It's a medical emergency that almost always
requires surgery as soon as possible to remove the appendix. Luckily, you can live just fine
without it.
There are two types of appendicitis:
Acute appendicitis. This is the most common type of appendicitis. Its symptoms start suddenly
and get worse quickly within a few hours.
Chronic appendicitis. Chronic appendicitis means that the appendix is inflamed, but it doesn’t
typically get any worse. While the symptoms are usually milder, the pain can return over weeks,
months, or even years. Because doctors know less about chronic appendicitis, it’s harder to
diagnose.
Appendicitis is an inflammation of the appendix, which is a 3 1/2-inch-long tube of tissue that
runs from your large intestine on the lower right side of your body. You can get appendicitis
from certain conditions, such as overgrowth of bacteria in your intestine, hardened poop, colitis,
or infection from parasites. (Photo credit: Eric Olson/WebMD)

Appendix Location
The appendix is a 3 1/2-inch-long tube of tissue that extends from your large intestine on the
lower right side of your body. The appendix has specialized tissue that can make antibodies, but
no one is completely sure what its function is.

Additional symptoms may develop later in some people. These can include:
  Fever. Up to 40% of people develop a fever. This means your immune system is kicking into a higher gear. It may
also mean inflammation is increasing or it may mean infection is spreading.
 Malaise. You may just notice that you feel generally unwell. You may lack energy or motivation and feel like
staying in bed, the way you do when you’re sick.
 Swollen belly. Your abdomen may look distended or feel bloated. This is usually an advanced symptom and may
indicate your appendix has ruptured.
 Urinary symptoms. You may feel like you have to pee more often or more urgently. This can happen if
appendicitis irritates nerves connected to your bladder.
 Bowel paralysis. When your body redirects blood flow from your bowels to your appendix, your bowels can
temporarily stop moving. Some people develop constipation and feel that they can’t pass gas. You may have the
sense that a bowel movement would relieve your symptoms.
 Diarrhea. Some people may have overactive bowels and more frequent poops. This may be because inflammation
from your appendix is irritating the end portion of your colon beside it.

 Blood tests: To check for signs of infection, such as having a high white blood cell count.
 Urine tests: To see if you have a urinary tract infection.

You may also have some imaging tests, including:

 Abdominal ultrasound: Lets the doctor see internal organs as they work and checks how blood is flowing
through different blood vessels.
 CT scan: Shows detailed images of any part of the body, such as the bones, muscles, fat, and organs.
 MRI: Sometimes used to diagnose appendicitis, especially in a pregnant woman, instead of CT scan.

The appendix may be removed in an open procedure or using laparoscopy:

 Open (traditional) surgery method. You are given anesthesia. A cut (incision) is made in the lower right-hand
side of your belly. The surgeon finds the appendix and takes it out. If the appendix has burst, a small tube (shunt)
may be placed to drain out pus and other fluids in the belly. The shunt will be taken out in a few days, when your
surgeon feels the infection has gone away.
 Laparoscopic method. You are given anesthesia. This surgery uses several small cuts (incisions) and a camera
(laparoscope) to look inside your belly. The surgical tools are placed through a few small incisions. The
laparoscope is placed through another incision. A laparoscopy can often be done even if the appendix has burst.

If your appendix has not burst then your recovery from an appendectomy will only take
a few days. If your appendix has burst, your recovery time will be longer and you will
need antibiotic medicine.
 HERNIA

HERNIA

A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes
through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. This
layer is called the fascia.

Types of hernia :

 Femoral hernia is a bulge in the upper thigh, just

below the groin. This type is more common in
women than men.
 Hiatal hernia occurs in the diaphragm muscle that
separates the chest and abdomen. Part of the
upper stomach pushes into the chest.
 Incisional hernia can occur through a scar if you
have had abdominal surgery in the past.
 Umbilical hernia is a bulge around the belly
button. It occurs when the muscle around the
belly button does not close completely after birth.
 Inguinal hernia is a bulge in the groin. It is more common in men. It may go all the way down
into the scrotum.

Causes

Usually, there is no clear cause of a hernia. Sometimes, hernias can occur due to:

 Heavy lifting

 Straining while using the toilet

 Any activity that raises the pressure inside the belly

Hernias may be present at birth, but the bulge may not be evident until later in life. Some people
have a family history of hernias.

Babies and children can get hernias. It happens when there is weakness in the belly wall.
Inguinal hernias are common in boys. Some children do not have symptoms until they are adults.

Any activity or medical problem that increases pressure on the tissue in the belly wall and
muscles may lead to a hernia, including:

 Long-term (chronic) constipation and pushing hard (straining) to have a bowel movement
 Chronic coughing or sneezing

 Cystic fibrosis
 Enlarged prostate, straining to urinate
 Extra weight

 Fluid in the abdomen (ascites)

 Peritoneal dialysis
 Poor nutrition

 Smoking

 Overexertion

 Undescended testicles
Symptoms

There are usually no symptoms other than a visible bulge. Some people have discomfort or pain.
The discomfort may be worse when standing, straining, or lifting heavy objects. In time, the
most common complaint is a bump that is sore and growing.

When a hernia gets bigger, it may get stuck inside the hole and lose its blood supply. This is
called strangulation. This causes pain and swelling at the site of strangulation. Symptoms may
include:

 Nausea and vomiting

 Not being able to pass gas or have bowel movements

When this occurs, surgery is needed right away.

Exams and Tests

The health care provider can usually see or feel a hernia when you are examined. You may be
asked to cough, bend, push, or lift. The hernia may get bigger when you do this.

The hernia (bulge) may not be easily seen in infants and children, except when the child is crying
or coughing.

Ultrasound or CT scan may be done to look for a hernia.

If there is a blockage in the bowel, an x-ray of the abdomen will likely be done.
Treatment

Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for
people with serious medical problems.
Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias
are closed with stitches and sometimes with mesh patches to plug the hole.

An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be
repaired.