The Digestive The Digestive System:System:

PathologyPathology

Chapter 5Chapter 5

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PathologyPathology

►Oral CavityOral Cavity Canker Sores (AKA Aphthous Ulcers)Canker Sores (AKA Aphthous Ulcers)

►Grey-white pits with a red borderGrey-white pits with a red border►Often associated with stress, certain foods, feverOften associated with stress, certain foods, fever

Dry Mouth (AKA Xerostomia)Dry Mouth (AKA Xerostomia)►Absence of or diminished amount of salivaAbsence of or diminished amount of saliva

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PathologyPathology

►Cold Sores (AKA Herpes labialis)Cold Sores (AKA Herpes labialis) Blisters on the lips or face caused by HSV-Blisters on the lips or face caused by HSV-

1 1 Most adults are infected, but only some Most adults are infected, but only some

experience the exacerbationexperience the exacerbation

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PathologyPathology

►Cleft Lip / PalateCleft Lip / Palate AKA harelipAKA harelip Congenital defect where the lip or the Congenital defect where the lip or the

palate or both fail to close properly and palate or both fail to close properly and result in a fissureresult in a fissure

If left can cause difficulty in eating or If left can cause difficulty in eating or speakingspeaking

Can be surgically correctedCan be surgically corrected

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PathologyPathology

►TeethTeeth BruxismBruxism

►Clenching or grinding of teethClenching or grinding of teeth►Associated with tension or stressAssociated with tension or stress

CariesCaries►Tooth decayTooth decay►Infectious disease that destroys the enamel Infectious disease that destroys the enamel

and dentinand dentin►May eventually expose the pulp and become May eventually expose the pulp and become

infectedinfected

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PathologyPathology

Dental PlaqueDental Plaque►Soft deposit of bacteria that builds up on teethSoft deposit of bacteria that builds up on teeth►Major cause of caries and periodontal diseaseMajor cause of caries and periodontal disease

CalculusCalculus►AKA tartarAKA tartar►Hardened dental plaque that irritates the Hardened dental plaque that irritates the

surrounding tissuessurrounding tissues GingivitisGingivitis

►Inflammation of the gumsInflammation of the gums►Earliest stage of periodontal Earliest stage of periodontal

diseasedisease

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PathologyPathology

►Temporomandibular disorders (TMD)Temporomandibular disorders (TMD) Group of symptoms including pain, Group of symptoms including pain,

headache, difficulty in chewing related to headache, difficulty in chewing related to problems with the TM jointproblems with the TM joint

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PathologyPathology

►EsophagusEsophagus GERD (Gastroesophageal Reflux Disease)GERD (Gastroesophageal Reflux Disease)

►Upward flow of stomach acid into the Upward flow of stomach acid into the esophagusesophagus

►Common cause of indigestionCommon cause of indigestion

AchalasiaAchalasia►Failure of the lower esophageal (cardiac) Failure of the lower esophageal (cardiac)

sphincter to relaxsphincter to relax►Due to a lack of peristalsisDue to a lack of peristalsis►-chalasia-chalasia means relaxation means relaxation

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PathologyPathology

Esophageal VaricesEsophageal Varices►Enlarged and swollen veins at the lower end of Enlarged and swollen veins at the lower end of

the esophagusthe esophagus►May rupture and bleedMay rupture and bleed

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PathologyPathology

►StomachStomach GastritisGastritis GastroenteritisGastroenteritis GastrorrheaGastrorrhea

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PathologyPathology

►UlcersUlcers Erosion of the skin or mucous membraneErosion of the skin or mucous membrane Frequently caused by Frequently caused by Helicobacter pyloriHelicobacter pylori

►Perforating Ulcer – erosion through entire wallPerforating Ulcer – erosion through entire wall►Gastric Ulcer – occur in stomachGastric Ulcer – occur in stomach►Duodenal Ulcer – occurs in small intestine Duodenal Ulcer – occurs in small intestine

(most common)(most common)

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UlcersUlcers

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PathologyPathology

►Eating DisordersEating Disorders Anorexia NervosaAnorexia Nervosa

►Characterized by a false perception of body Characterized by a false perception of body appearanceappearance

►Compulsive dieting and/or exercise lead to Compulsive dieting and/or exercise lead to emaciationemaciation (abnormal thinness) (abnormal thinness)

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PathologyPathology

Bulimia nervosaBulimia nervosa►False perception of body image leads to False perception of body image leads to

episodes of binge eating followed by episodes of binge eating followed by compulsive behaviours like vomiting or misuse compulsive behaviours like vomiting or misuse of laxatives, etcof laxatives, etc

►BulimiaBulimia means excessive, continuous hunger means excessive, continuous hunger

PicaPica►Persistent eating of non-food substancesPersistent eating of non-food substances

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PathologyPathology

►Nutritional ConditionsNutritional Conditions DehydrationDehydration

►Fluid loss exceeds fluid intakeFluid loss exceeds fluid intake►Disrupts electrolyte balanceDisrupts electrolyte balance

MalnutritionMalnutrition►Lack of proper food or nutrients due to Lack of proper food or nutrients due to

shortage in intake or shortage in intake or malabsorption (malabsorption (a a condition in which the small intestine cannot condition in which the small intestine cannot absorb nutrients)absorb nutrients)

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PathologyPathology

► Indigestion and VomitingIndigestion and Vomiting AerophagiaAerophagia

►Excessive swallowing of air while eating or Excessive swallowing of air while eating or drinkingdrinking

►Aer/oAer/o means air means air

DyspepsiaDyspepsia►Pain or discomfort in digestionPain or discomfort in digestion►-pepsia-pepsia means digestion means digestion

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PathologyPathology

► IntestinesIntestines DiverticulumDiverticulum

►Pouch or sac occurring in the Pouch or sac occurring in the wall of a tubular organwall of a tubular organ

DiverticulitisDiverticulitis►Inflammation of a diverticulumInflammation of a diverticulum

DiverticulosisDiverticulosis►Presence of several diverticula in Presence of several diverticula in

the colonthe colon

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PathologyPathology

EnteritisEnteritis►Inflammation of the small intestineInflammation of the small intestine►Caused by eating or drinking contaminated Caused by eating or drinking contaminated

substancessubstances IleusIleus

►Partial or complete blockage of the intestinesPartial or complete blockage of the intestines►Caused by cessation of peristalsisCaused by cessation of peristalsis►Symptoms include pain, cramping, abdominal Symptoms include pain, cramping, abdominal

distension, vomiting, failure to pass gas or distension, vomiting, failure to pass gas or defecatedefecate

►Often occurs after abdominal surgeryOften occurs after abdominal surgery

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PathologyPathology

IrritableIrritable Bowel Syndrome Bowel Syndrome►AKA Spastic ColonAKA Spastic Colon►Idiopathic condition that results in cramping, Idiopathic condition that results in cramping,

abdominal pain, bloating, constipation, abdominal pain, bloating, constipation, diarrheadiarrhea

►Usually aggravated by stressUsually aggravated by stress

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PathologyPathology

Inflammatory Bowel DiseasesInflammatory Bowel Diseases►Chronic, incurable diseases that result in Chronic, incurable diseases that result in

intestinal inflammationintestinal inflammation►Symptoms include pain, weight loss, fatigue, Symptoms include pain, weight loss, fatigue,

fever, rectal bleeding, diarrheafever, rectal bleeding, diarrhea►Often have a cycle of flares and remissionsOften have a cycle of flares and remissions►Treatment includes medication and surgery to Treatment includes medication and surgery to

remove diseased tissueremove diseased tissue

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PathologyPathology

►Examples of IBD’sExamples of IBD’s Ulcerative ColitisUlcerative Colitis

►IdiopathicIdiopathic►Repeated episodes of Repeated episodes of

inflammation inflammation in the rectum and colon cause in the rectum and colon cause ulcers and irritationulcers and irritation

►Affects only lining of the colonAffects only lining of the colon

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PathologyPathology

Crohn’s DiseaseCrohn’s Disease►Autoimmune disorderAutoimmune disorder►Can occur anywhere in the digestive tractCan occur anywhere in the digestive tract►Penetrates every layer of tissue – results in Penetrates every layer of tissue – results in

scarring and thickening of wallsscarring and thickening of walls►AKA ileitis, crohn’s colitisAKA ileitis, crohn’s colitis

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PathologyPathology

► Intestinal ObstructionsIntestinal Obstructions Partial or complete blockage due to Partial or complete blockage due to

physical obstructionphysical obstruction►Adhesions – bands of fibrous tissue that Adhesions – bands of fibrous tissue that

abnormally connect the intestines to each abnormally connect the intestines to each other, to other organs, or to the abdominal other, to other organs, or to the abdominal wallwall

►Strangulating obstruction – blood flow to a Strangulating obstruction – blood flow to a segment of the intestine is cut off (leads to segment of the intestine is cut off (leads to gangrene or perforation)gangrene or perforation)

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PathologyPathology

►Volvulus – twisting of the Volvulus – twisting of the intestine (usually occurs intestine (usually occurs in infancy)in infancy)

► Intussusception – Intussusception – telescoping of one part of telescoping of one part of the small intestine into the small intestine into anotheranother

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PathologyPathology

►Infectious diseases of the intestinesInfectious diseases of the intestines Amebic DysenteryAmebic Dysentery

►Symptoms: loose stool, pain, crampingSymptoms: loose stool, pain, cramping►Transmitted by contaminated food or waterTransmitted by contaminated food or water

BotulismBotulism►Symptoms: Paralysis, deathSymptoms: Paralysis, death►AKA food poisoning (rare)AKA food poisoning (rare)

CholeraCholera►Symptoms: diarrhea, vomiting, rapid dehydrationSymptoms: diarrhea, vomiting, rapid dehydration►Transmitted by contaminated food or waterTransmitted by contaminated food or water

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Infectious DiseasesInfectious Diseases

E.coliE.coli►Symptoms: bloody diarrhea, abdominal crampingSymptoms: bloody diarrhea, abdominal cramping►Transmitted through undercooked foodTransmitted through undercooked food

SalmonellaSalmonella►Symptoms: diarrhea, nausea, vomiting, high Symptoms: diarrhea, nausea, vomiting, high

feverfever►Transmitted by fecal contaminated foodTransmitted by fecal contaminated food

Typhoid FeverTyphoid Fever►Symptoms: headache, delirium, cough, watery Symptoms: headache, delirium, cough, watery

diarrhea, rash, high feverdiarrhea, rash, high fever►Caused by eating food that has been handled by Caused by eating food that has been handled by

a carriera carrier

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PathologyPathology

►HerniasHernias Occurs when part of an organ protrudes Occurs when part of an organ protrudes

through a weak point or tear in the thin through a weak point or tear in the thin muscular wall that holds the abdominal organs muscular wall that holds the abdominal organs in place. in place.

Types:Types:►HiatalHiatal – protrusion of the – protrusion of the

stomach through the stomach through the esophageal sphincter in the esophageal sphincter in the diaphragmdiaphragm

►IncisionalIncisional – protrusion of a – protrusion of a loop of the intestines through loop of the intestines through a weak point created by surgerya weak point created by surgery

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PathologyPathology

►InguinalInguinal – protrusion of a – protrusion of a loop of the intestines through loop of the intestines through the lower abdominal wall or the lower abdominal wall or groingroin

►Umbilical Umbilical – protrusion of a – protrusion of a loop of the intestines through loop of the intestines through the weak point at the umbilicusthe weak point at the umbilicus

►StrangulatedStrangulated – occurs when – occurs when blood supply is cut off from the blood supply is cut off from the herniated tissueherniated tissue

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PathologyPathology

►Anorectal disordersAnorectal disorders Anal fissureAnal fissure

►Small tear in the skin of the anusSmall tear in the skin of the anus►Causes pain during bowel movementsCauses pain during bowel movements

Bowel incontinenceBowel incontinence►Inability to control defecationInability to control defecation

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PathologyPathology

HemorrhoidsHemorrhoids►AKA pilesAKA piles►Cluster of veins, muscles, and Cluster of veins, muscles, and

tissues slip near or through the tissues slip near or through the anal openinganal opening

►Veins become inflamed and Veins become inflamed and lead to pain, fecal leaking, and lead to pain, fecal leaking, and bleedingbleeding

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PathologyPathology

► LiverLiver HepatomegalyHepatomegaly HepatitisHepatitis

►Inflammation of the liverInflammation of the liver►Caused by a virus (5 kinds A-E)Caused by a virus (5 kinds A-E)

**Hepatitis A is spread by contaminated food **Hepatitis A is spread by contaminated food and water and water

**Hepatitis B is spread through contaminated **Hepatitis B is spread through contaminated blood and sexual contactblood and sexual contact

Hepatitis C is spread through contaminated Hepatitis C is spread through contaminated bloodblood

Hepatitis D only develops in the presence of Hepatitis D only develops in the presence of Hepatitis BHepatitis B

**vaccine available**vaccine available

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PathologyPathology

CirrhosisCirrhosis►Degenerative disease of the liverDegenerative disease of the liver►Scar tissue replaces normal tissueScar tissue replaces normal tissue►Blocks the flow of blood, so jaundice may Blocks the flow of blood, so jaundice may

resultresult►Also may lead to ascites and brain or kidney Also may lead to ascites and brain or kidney

damagedamage

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PathologyPathology

►GallbladderGallbladder CholecystalgiaCholecystalgia CholecystitisCholecystitis

►Usually associated with gallstones blocking Usually associated with gallstones blocking the flow of bilethe flow of bile

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PathologyPathology

GallstonesGallstones►AKA biliary calculi, cholelithAKA biliary calculi, cholelith►Hard deposit that forms in the gallbladder and Hard deposit that forms in the gallbladder and

bile ductsbile ducts

CholelithiasisCholelithiasis►Presences of gallstonesPresences of gallstones►-lithiasis-lithiasis means presence means presence

of stonesof stones

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Diagnostic ProceduresDiagnostic Procedures

►CT ScanCT Scan Radiographic cross-sectional analysis of Radiographic cross-sectional analysis of

tissue structuretissue structure►UltrasoundUltrasound

Uses sound waves to visualize soft tissuesUses sound waves to visualize soft tissues►Capsule EndoscopyCapsule Endoscopy

AKA Given Diagnostic Imaging systemAKA Given Diagnostic Imaging system Patient swallows a capsule with a tiny Patient swallows a capsule with a tiny

camera insidecamera inside

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Diagnostic ProceduresDiagnostic Procedures

► EsophagogastroduodenoscopyEsophagogastroduodenoscopy► AnoscopyAnoscopy► ColonoscopyColonoscopy► SigmoidoscopySigmoidoscopy► Upper and Lower GI SeriesUpper and Lower GI Series

Contrast media are used to help display Contrast media are used to help display the tissues of the digestive tractthe tissues of the digestive tract

► Fecal Occult Blood TestFecal Occult Blood Test AKA HemoccultAKA Hemoccult Test for blood in stoolTest for blood in stool

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TreatmentsTreatments

►MedicationsMedications AntacidsAntacids EmeticsEmetics AntiemeticsAntiemetics LaxativesLaxatives

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TreatmentTreatment

► Oral Cavity and EsophagusOral Cavity and Esophagus GingivectomyGingivectomy PalatoplastyPalatoplasty Dental prophylaxisDental prophylaxis

►Cleaning of teeth to remove plaque and calculusCleaning of teeth to remove plaque and calculus

► StomachStomach GastrectomyGastrectomy Gastric bypassGastric bypass Nasogastric intubation – used for artificial feedingNasogastric intubation – used for artificial feeding

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TreatmentTreatment

► IntestinesIntestines ColectomyColectomy DiverticulectomyDiverticulectomy Hemorrhoidectomy Hemorrhoidectomy

►May also use ligationMay also use ligation GastroduodenostomyGastroduodenostomy

►Removal of the pylorus and creation of an Removal of the pylorus and creation of an anastomosis between the rest of the stomach anastomosis between the rest of the stomach and the small intestineand the small intestine Anastomosis: surgical connection between Anastomosis: surgical connection between

two hollow organstwo hollow organs

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TreatmentTreatment

►OstomiesOstomies Creation of an opening (stoma) between a hollow Creation of an opening (stoma) between a hollow

organ and the body surfaceorgan and the body surface►ColostomyColostomy►IleostomyIleostomy►GastrostomyGastrostomy

► Rectum and AnusRectum and Anus ProctectomyProctectomy ProctopexyProctopexy

►-pexy-pexy means surgical fixation of a prolapsed means surgical fixation of a prolapsed organorgan

ProctoplastyProctoplasty

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TreatmentTreatment

► LiverLiver HepatectomyHepatectomy HepatorrhaphyHepatorrhaphy Liver transplantLiver transplant

►May be full or partial (if partial, usually May be full or partial (if partial, usually donated by a living relative)donated by a living relative)

►GallbladderGallbladder CholedocholithotomyCholedocholithotomy CholecystectomyCholecystectomy

►Laparoscopic cholecystectomyLaparoscopic cholecystectomy