Gastointestinal
diseases
1. Crohn Disease
·
The
exact cause of inflammatory bowel disease (IBD) is unknown, although there are
components that appear to be infectious and other components that suggest
immune dysregulation.
·
Ulcerative
colitis and Crohn disease
·
Genetic
variations explain some of the increased risk of disease occurrence.
·
The
severity of Crohn’s disease can be assessed by the Crohn’s disease activity
index, which includes stool frequency, presence of blood in stool, endoscopic
appearance, and physician’s global assessment.
·
The
goals of treatment of IBD are resolution of acute inflammation and
complications, alleviation of systemic manifestations, maintenance of
remission, and in some patients, surgical palliation or cure.
2. GERD
·
Symptoms,
such as heartburn,and for signs and symptoms of complications that require
immediate medical attention, such as dysphagia or bleeding.
·
Endoscopy
is used to evaluate mucosal damage from gastroesophageal reflux disease (GERD)
and assess for the presence of Barrett’s esophagus (BE); 24-hour ambulatory pH
testing or a therapeutic trial of a proton pump inhibitor are useful for
diagnosing GERD in patients with persistent symptoms or atypical symptoms;
manometry is useful in evaluating motility and before antireflux surgery.
·
The
goals of treatment of GERD are to alleviate symptoms,to decrease the frequency
of recurrent disease, to promote healing of mucosal injury, and to prevent
complications.
·
Patient
medication profiles should also be reviewed for drugs that may aggravate GERD.
Patients should be monitored for adverse drug reactions and potential drug-drug
interactions of drugs used to treat GERD. Finally, patients should be assessed
for compliance to their therapeutic regimen.
3. IBS (Irritable Bowel Syndrome)
·
Irritable
bowel syndrome is one of the most common gastrointestinal disorders, and is
characterized by lower abdominal pain, disturbed defecation, and bloating. Many
nongastrointestinal manifestations also exist with IBS. Recent studies have
found that visceral hypersensitivity is a major culprit in the pathophysiology
of the disease.
·
IBS
results from altered somatovisceral and motor dysfunction of the intestine from
a variety of causes. Abnormal central nervous system processing of afferent
signals may lead to visceral hypersensitivity, with the specific nerve pathway
affected determining the exact symptomatology expressed. This visceral
hypersensitivity is a neuroenteric phenomenon that is independent of motility
and psychological disturbances.
·
Factors
known to contribute to these alterations include genetics, motility factors,
inflammation, colonic infections, mechanical irritation to local nerves, and
psychological factors
4. Ileus Paralysis
·
Paralysis
of the intestine. The intestinal paralysis need not be complete, but it must be
sufficient to prohibit the passage of food through the intestine and lead to
intestinal blockage.
·
Paralytic
ileus is a common aftermath of some types of surgery. It can also result from
certain drugs and from various injuries and illnesses. Paralytic ileus causes
constipation and bloating. On listening to the abdomen with a stethoscope, no
bowel sounds are heard because the bowel is inactive
5. Cirrhosis
o
Cirrhosis
is a severe, chronic, irreversible disease associated with significant
morbidity and mortality. However, the progression of cirrhosis secondary to
alcohol abuse can be interrupted by abstinence. It is therefore imperative for
the clinician to educate and support abstinence from alcohol as part of the
overall treatment strategy of the underlying liver disease.
o
Cirrhosis
is defined as a diffuse process characterized by fibrosis and a conversion of
the normal hepatic architecture into structurally abnormal nodules.
o
Regardless
of the mechanism of injury, the end result is the destruction of hepatocytes
and their replacement with fibrous tissue. As fibrotic tissue replaces normal
hepatic parenchyma, resistance to blood flow results in the clinical problems
of portal hypertension and the development of varices and ascites
o
Hepatocyte
loss and intrahepatic shunting of blood results in diminished metabolic and
synthetic function, which leads to hepatic encephalopathy and coagulopathy
6. Cholelithiasis
·
the
presence of stones in the gallbladder or bile ducts
·
gallstones
may be caused by a combination of factors, including inherited body chemistry,
bw, gallbladder motility (movement), and perhaps diet.
·
Cholesterol
gallstones develop when bile contains too much cholesterol and not enough bile
salts. Besides a high concentration of cholesterol, two other factors seem to
be important in causing gallstones. The first is how often and how well the
gallbladder contracts; incomplete and infrequent emptying of the gallbladder
may cause the bile to become overconcentrated and contribute to gallstone
formation. The second factor is the presence of proteins in the liver and bile
that either promote or inhibit cholesterol crystallization into gallstones.
·
In
addition, increased levels of the hormone estrogen as a result of pregnancy, hormone
therapy, or the use of combined (estrogen-containing) forms of contraception,
may increase cholesterol levels in bile and also decrease gallbladder movement,
resulting in gallstone formation.
Riset terbaru
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justru bisa mempercepat kematian virus cacar air. Hal ini dikemukakan Dr.Phil
Rice dari St.George University, London. Ia menganalisa data 25 studi tentang virus
varisela--sebutan lain dari virus cacar air.