Symptoms of Gastrointestinal Disease VIDEO

Gastrointestinal diseases refer to diseases of the esophagus, stomach, small intestine, large intestine and rectum, the liver, gallbladder, and pancreas.

 

Common Gastrointestinal symptoms that have been associated with anxiety disorders include:

1. Irritable Bowel Syndrome (IBS)

• Stomach pain
• Flatulence (gas)
• Bloated or swollen abdomen
• Diarrhea, constipation or a combination of both
• Whitish mucus in the stool

2. Gastroesophageal reflux disease (GERD)

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What are the symptoms of biliary atresia?

The first hint of biliary atresia is jaundice, which causes a yellow-colored colour to the skin and to the white-colored wines of the little brown eyes. Jaundice is due to the liver organ not getting rid of bilirubin, a yellow-colored color from the body. Normally, bilirubin is taken up by the liver organ and produced into the bile. However, obstruction of the bile channels causes bilirubin and other features of bile to create up in the body.

Jaundice may be hard for mother and father and even physicians to diagnose. Many balanced children have slight jaundice during the first 1 to 2 months of lifestyle due to immaturity of the liver organ. This standard kind of jaundice vanishes by the second or third A week of lifestyle, whereas the jaundice of biliary atresia increases. Newborns with jaundice after 2 months of lifestyle should be taken to the medical professional to test for a possible liver organ challenge.

Other symptoms of jaundice are a darkening of the pee and a whitening in large of colon motions. The pee darkens from the high stages of bilirubin in the body dropping over into the pee, while chair lightens from a insufficient bilirubin attaining the colon. Passed, greyish, or white-colored colon motions after 2 months of age are probably the most efficient hint of a liver organ challenge and should fast a trip to the medical professional.

Abbey's Story
Abbey was born with Biliary Atresia. It occurs in 1 in 15,000 births. There are no known causes or modifiable risk factors. Abbey underwent an unsuccessful "life-extending" operation at 6-8 weeks of age. Abbey subsequently developed progressive liver failure. The only cure for Biliary Atresia is liver transplatation. Being an organ donor can save 6 or more lives. Discover, Discuss and Decide. www.donatelife.gov.au

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Liver Transplant Causes, Symptoms

Liver Transplant Overview

Currently, more than 17,000 people in the United States are waiting for liver transplants. According to the United Network for Organ Sharing (UNOS), about5,300 liver transplantations were performed in the United States in 2002.
The liver is the second most commonly transplanted major organ, after the kidney, so it is clear that liver disease is a common and serious problem in this country. It is important for liver transplant candidates and their families to understand the basic process involved with liver transplants, to appreciate some of the challenges and complications that face liver transplant recipients (people who receive livers), and to recognize symptoms that should alert recipients to seek medical help.

Determining whose need is most critical: The United Network for Organ Sharing uses measurements of clinical and laboratory problems to divide patients into groups that determine who is in most critical need of a liver transplant. In early 2002, UNOS enacted a major modification to the way in which people were assigned the need for a liver transplant. Previously, patients awaiting livers were ranked as status 1, 2A, 2B, and 3, according to the severity of their current disease. Although the status 1 listing has remained, all other patients are now classified using the Model for End-Stage Liver Disease (MELD) scoring system if they are aged 18 years or older, or the Pediatric End-Stage Liver Disease (PELD) scoring system if they are younger than 18 years. These scoring methods were set up so that donor livers could be distributed to those who need them most urgently.

Who may not be given a liver: A person who needs a liver transplant may not qualify for one because of the following reasons:

    Active alcohol or substance abuse: Persons with active alcohol or substance abuse problems may continue living the unhealthy lifestyle that contributed to their liver damage. Transplantation would only result in failure of the newly transplanted liver.

•     Cancer: Cancers in locations other than just the liver weigh against a transplant.
•     Advanced heart and lung disease: These conditions prevent a transplanted liver from surviving.
•     Severe infection: Such infections are a threat to a successful procedure.
•     Massive liver failure: This type of liver failure accompanied by associated brain injury from increased fluid in brain tissue rules against a liver transplant.
•     HIV infection

Liver Transplant Causes

Liver disease severe enough to require a liver transplant can come from many causes. Doctors have developed various systems to determine the need for the surgery. Two commonly used methods are by specific disease process or a combination of laboratory abnormalities and clinical conditions that arise from the liver disease. Ultimately, the transplantation team takes into account the type of liver disease, the person's blood test results, and the person's health problems in order to determine who is a suitable candidate for transplantation.

In adults, chronic active hepatitis and cirrhosis (from alcoholism, unknown cause, or biliary) are the most common diseases requiring transplantation. In children, and in adolescents younger than 18 years, the most common reason for liver transplantation is biliary atresia, which is an incomplete development of the bile duct.

Liver Transplant Symptoms

People who have liver disease may have many of the following problems:

•     Jaundice - Yellowing of the skin or eyes
•     Itching
•     Dark, tea-colored urine
•     Gray- or clay-colored bowel movements
•     Ascites - An abnormal buildup of fluid in the abdomen
•     Vomiting of blood
•     Tendency to bleed
•     Mental confusion, forgetfulness

Read more about liver problems:

Liver disease Problems, Symptoms and Causes
Prevent liver Problems

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Liver disease, problems, symptoms and causes

Your liver is the largest organ inside your body. It is also one of the most important. The liver has many jobs, including changing food into energy and cleaning alcohol and poisons from the blood. Your liver also makes bile, a yellowish-green liquid that helps with digestion.

Definition
Liver problems include a wide range of diseases and conditions that can affect your liver. Your liver is an organ about the size of a football that sits just under your rib cage on the right side of your abdomen. Without your liver, you couldn't digest food and absorb nutrients, get rid of toxic substances from your body or stay alive.

Liver problems can be inherited, or liver problems can occur in response to viruses and chemicals. Some liver problems are temporary and go away on their own, while other liver problems can last for a long time and lead to serious complications.

Symptoms
Signs and symptoms of liver problems include:

•     Discolored skin and eyes that appear yellowish
•     Abdominal pain and swelling
•     Itchy skin that doesn't seem to go away
•     Dark urine color
•     Pale stool color
•     Bloody or tar-colored stool
•     Chronic fatigue
•     Nausea
•     Loss of appetite

Causes

Problems that can occur in the liver include:

•     Acute liver failure
•     Alcoholic hepatitis
•     Alpha-1-antitrypsin deficiency
•     Autoimmune hepatitis
•     Bile duct obstruction
•     Chronic liver failure
•     Cirrhosis
•     Enlarged liver
•     Gilbert's syndrome
•     Hemochromatosis
•     Hepatitis A
•     Hepatitis B
•     Hepatitis C
•     Hepatitis D
•     Hepatitis E
•     Liver adenoma
•     Liver cancer
•     Liver cyst
•     Liver hemangioma
•     Liver nodule (focal nodular hyperplasia)
•     Nonalcoholic fatty liver disease
•     Parasitic infection
•     Portal vein thrombosis
•     Primary biliary cirrhosis
•     Toxic hepatitis
•     Wilson's disease

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Symptoms of Hepatitis C [VIDEO]

This video gives information on the symptoms of Hepatitis C. These include fatigue, fluid retention, skin itching, and bleeding vericies.

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Hepatitis B, causes, symptoms, diagnosis [VIDEO]

This education video explains what hepatitis B is. It discusses its causes, symptoms, diagnosis, treatment, and prevention.

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Gastroesophageal reflux disease, Etiopathogenesis, Symptoms, Diagnosis

Definition of Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) includes all the symptoms that result from ferux of gastric content into the  esophagus.
Gastroesophageal reflux (GERD) represents the physiologic phenomenon of gastric content passage into the esophagus, which becomes pathological when the antireflux mechanisms are surpassed.
Reflux esophagitis (RE) consists of esophageal lesions induced by GER, occurring only in certain cases of pathological GER.

Etiopathogenesis (causes)
A. Physiologic causes:

• Decreasing of the lower esophageal sphincter (LES) pressure. Normally the LES pressure is 20-25 mmHg and it only disappears during swallowing. GER occurs either when LES transiently relaxes because of swallowing, or when the LES basal pressure decreases less than 6 mmHg, thus allowing the castric content to pass into the esophagus. LESpressure can be reduced by drugs (anticholinergic, aminophylline, nitrates, benzodiazepines, calcium channel blockers), food (chocolate, fatty foods, onion, citric, tomato juice mint), coffee, smoking, alcohol.
• Decreasing of gastric motility with delayed gastric emptying.
• Disorder of esophageal clearance by refluxed acid gastric content.

B. Mechanical causes:

• Hiatal hernia – produces a decrease in LES tonus, which allows the reflux.
• Increasing of intraabdominal pressure: pregnant women, obese, patients with giant abdominal tumors or ascites.
• The widening of his angle. This angle between the esophagus and stomach is usually very sharp, having the role of a valve at the stomach entrance. In the obese, it enlarges.
• The relaxation of diaphragmatic crura, the muscular channel through which the esophagus passes from thorax into the abdomen. The relaxation cavity volume increases (emphysema).
• Sclerodermia. The motor disorders of the esophagus are the result of fibrosis and atrophy of the smooth muscle, the so-called “glass-esophagus”.

The development and severity of reflux esophagitis depend on 3 conditions:

• the increasing of reflux frequency
• the increasing of reflux duration
• the action of aggressive gastric content of the esophageal mucosa

Clinical features (symptoms)

• Pyrosis is characterized by burning retrosternal discomfort, climbing up the throat. It is aggravated by maneuvers that increase intraabominal pressure (bending forward, load straining, lying recumbent immediately after eating) accompanied sometimes by acid regurgitations as well. If the LES incompetence is severe, solid food can also be regurgitated.
• Retrosternal pain is often a problem of differential diagnosis with the cardiac pathology. It may appear isolated, without pyrosis, mainly when ingesting irritating food. Odynophagia (painful swallowing) appears during spastic contractions of LES. Dyspagia – difficult swallowing.
• Respiratory symptoms (stifling, nocturnal dyspneea, asthma crises) or ENT (laryngitis, pharyngeal paralysis, dysphonia) are due to the regurgitation of refluxed acid gastric content and its aspiration.

Paraclinical findings (investigations)

• Superior digestive andoscopy (esogastrocopy). When confronting with annoying, persistent esophageal symptoms (mainly pain or dysphagia), an esogastroscopy will be done. It will reveal or exclude the possible esophageal lesions (esopagitis, stenosis)., gastroduodenal lesion. Also by means of endoscopy, a discovered lesion may be diopsied.
• Barium examination it may show the esophageal motor disorders (achalasia, esophageal diffuse spasm), a possible esophageal stenosis, a hiatal hernia.
• Esophageal pH – metry is very useful to discover the reflux duration.
• Esophageal manometry allows the subtle discovering of esophageal motor disorders and their possible linking to the clinical symptoms.

Other tests, more rarely used are esophageal scintigraphy or the Berstein test.
Diagnosis of Gastroesophageal reflux disease
Positive diagnosis – is mainly clinical, but most be paraclinical confirmed.

Differential diagnosis
A. With digestive diseases:

• gastroduodenal ulcer having as typical symptom the epigastric pain;
• the differenciation between the acid reflux and the alkaline one (mostly after colecistectomy), when the patient complains of bitter taste in the morning.
• the esophageal diverticula’s, achalasia, esophageal ulcer or cancer.

B. With nondigestive digeases:

• retrosternal or thoracic pain must be differentiated from a cardiac pain (ECG or the effort test is necessary; in doubtful cases, coronarography is useful)
• the bronchic asthma crisis may be sometimes induced by the acid reflux, therefore, correlating the crises with pH – metry may be useful for the therapy.

Evolution, complications
The evolution is prolonged with good periods alternating with less good ones, generally because of food intake and life style.

The complications of reflux disease are:

• reflux esophagitis, of different degrees, resulting in esophageal peptic ulcer and esophageal stenosis.
• The Barrett epithelium (endobranchiesophagus) is a columnar epithelial metaplasia of normal squamous mucosa, because of reflux disease healing, after acid exposure, and it represents a premalignant condition to the esophageal cancer.
• Superior digestive hemorrhage (hematemesis and/or melena) is a rare complication. It generally appears as melena, because the hemorrhages are mild, produced by ulcer or severe esophagitis.

Treatment of Gastroesophageal reflux disease
A. Diet

• dietary restrictions: avoiding bulky meals, avoiding food that decreases LES pressure:coffee, chocolate, carbonated drinks, mint products, fatty foods, alcohol or foods that increase the acid secretion: orange juice, carbonated drinks, white vine, and acid food);
• avoiding smoking. It is said that smoking increases the acid secretion and lowers the LES pressure;
• avoiding lying recumbent immediately after eating;
• weight loss in the obese patients (reducing the abdominal pressure);
• avoiding medications that decrease the LES pressure: nifedipin (calcium channel blockers), nitrates, aminophylline, caffeine and anticholinergics. These are also studies suggesting that NSAIDS and aspirin are associated with esophageal lesions, being able to induce esophagitis and even esophageal strictures.

B. Medication – involves 2 types of drugs:

1. Antisecretory drugs. This treatment decreases the acid secretion:
Proton pump blockers are the most potent antisecretory drugs:

• Esomeprazole (Nexium) 40 mg/day.
• Omeprazole (Losec, Ultop, Antra) 20 mg bid;
• Pantoprazole (Controloc) 40 mg/day;
• Lanzoprazole (Lanzap) 30 mg/day;
• Rabeprazole 20 mg/day;

The duration of treatment is 4-8 weeks, or a few months in resistant cases.
H2 blocking agents:

• Ranitidine 150 mg bid;
• Famotidine 40 mg/day;
• Nizatidine (Axid) 150 mg bid.
• H2 blocking agents; they may be used 2-6 weeks or even more in resistant cases.

2. Prokinetic

• Metoclopramide, 10 mg tid, 30 bid minutes before meals. Its effect  is the increasing of LES tone; it also increases the esophageal clearance and hastens the gastric emptying.
• Domperidone (Motilium) is effective on the LES and gastrokietic; the effect on the reflux is lower than that of Metoclopramide.

3. Antiacids - medication with direct neutralizing effect: Maalox, Novalox, Rennie, Dicarbocalm, containing magnesium and aluminium salts; the patients se them when the symptoms appear, with a spectacular disappearance of symptoms. They effect is only symptomatic, the esophagitis lesions persisting. An interesting drug of this group is the sodium alginate (Gaviscon, Nicon), which forms a protective layer over the esogastric mucosa.
4. Mucosal protectives. Sucralfate is an aluminium polisulfatate sucrose, which links the billiary acids and pepsin and stimulates the gastric secretion of prostaglandins and epidermic growth factor, thus favoring the epithelium healing. It is sometimes indicated in esophagitis.
The strategy of treatment is to begin, generally, in case of acid reflux, with PPI, in case of failure, a prokinetic is added. If the patients complain of billiary reflux, the therapy will be prokinetic.
C. Endoscopic

• Esophageal structures. The most preffered treatment in peptic strictures is done endoscopically, by Savary probe dilators or pressure balloons.
• Superior digestive hemorrhage. The severe cases require endoscopic hemostasis by Adrenaline injections, Argon Beamer photocoagulation or hemoclips application.
• Barrett’s esophagus. The columnar epithelium patches with different degrees of dysplasia may be destroyed by Argon plasma photocoagulation.
• Endoscopic fondoplicature – represents a new noninvasive method, in which the gastric fundus is wrapped around the esophagus thus creating a very sharp His angle.

D. Surgical
In rare cases with severe esophagitis without response to drug therapy, surgery may be needed.                                       

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Achalasia - Symptoms, Diagnosis and Treatment

Definition

The main elements are the LES hipertony, the lack of relaxation of LES with swallowing and the absence of the normal peristaltic in the 2/3 inferior esophagus. Practically there is on relaxation of LES during swallowing.

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