Disorders & Conditions of the Digestive System

These short notes about some conditions and disorders of the human digestive system list the conditions in alphabetical order.

Term

Definition

Cause

Effect (Symptoms)

Appendicitis

Appendicitis is inflammation of the appendix.

Acute Appendicitis became common in the 20th century (approx. the last 100 years), usually affecting young people, including children. Unusual positions of the appendix may result in pain at different locations, causing difficulty in diagnosis.

Chronic Appendicitis was a common diagnosis in the 1950s - 1970s to explain recurrent pains in the lower abdomen. Chronic appendicitis is rare and such pains are not usually cured by an appendicectomy.

  • The first symptom is usually abdominal pain, initially central, then later (with tenderness) in the right-lower abdomen, over the appendix.
  • Abdominal pain is sometimes accompanied by vomiting and diarrhea - though any fever is slight.

If not treated by surgical removal (appendicectomy) of the appendix, appendicitis may progress to cause an abscess, or generalised peritonitis. Recurrent pains in the lower abdomen might also be expected.

Cirrhosis of the liver

Cirrhosis of the liver is a condition in which the liver responds to the injury of death of some of its cells by producing interlacing strands of fibrous tissue, between which are nodules of re-generating cells. The liver therefore becomes tawny and characteristically knobbly (due to the nodules).

Possible causes include:

  • Alcoholism
    (alcoholic cirrhosis)
  • Viral hepatitis
    (postnecrotic cirrhosis)
  • Chronic obstruction of the common bile duct
    (secondary bilary cirrhosis)
  • Auto-Immune Diseases (chronic aggressive hepatitis, primary biliary cirrhosis)
  • Chronic heart failure
    (cardiac cirrhosis)

Complications can include:

  • Portal hypertension
  • Ascites (accumulation of fluid in the peritoneal cavity)
  • Hepatic encephalopathy
  • Hepatoma

Medical opinion is that cirrhosis cannot be cured but its progress may be stopped if the cause is removed.

Jaundice is a yellowing of the skin or the whites of the eyes, indicating excess bilirubin (which is a bile pigment) in the blood. There are three types of jaundice - each of which can be treated separately:

Obstructive jaundice

Obstructive jaundice happens when bile made in the liver fails to reach the intestines due to obstruction of the bile ducts. Such obstruction may be due to gall stones or to cholestasis.

  • Dark Urine
  • Pale faeces
  • Itching

Hepatocellular jaundice

Hepatocellular jaundice is caused by diseased liver cells - e.g. in hepatitis, when the liver is not able to utilize bilirubin so it accumulates in the blood.

  • Urine may be dark, but faeces retain colour

Haemolytic jaundice

Haemolytic jaundice occurs when there is excessive destruction of red cells (erythrocytes) in the blood. This situation may be referred to by the medical term "icterus".

  • Urine and faeces of normal colour.

Heartburn
(also known as "pyrosis")

See "Effect"
(far right column)

Usually caused by re-gurgitation of contents of the stomach into the oesophagus, or by oesophagitis.

Discomfort or pain, usually "burning" pain, that is felt behind the sternum (breastbone) and often seems to rise from the abdomen towards or into the throat. This pain may be accompanied by the sensation of of acid or bitter fluid in the mouth.

Hernia

The protrusion of an organ or tissue outside of the body cavity inside which it is normally located.

The most common type of hernia is the hiatus hernia, in which the stomach passes, partly or completely, into the chest cavity through the hole ("hernia") for the oesophagus (which is also known colloquially as the "windpipe" or "gullet").

Complications of hernias may include the hernia becoming:

  • impossible to return to their normal state (irreducible).
  • swollen and fixed within their sac (incarcerated).
  • cut-off from their blood supply, becoming painful and eventually gangrenous (strangulated).

The usual medical treatment for hernias (especially painful ones) is surgical repair.

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is also known as "IBS", "spastic colon", and "mucous colitis".

This is a common condition in which recurrent abdominal pain in combination with constipation and / or diarrhea can persist for years without other more general deterioration in the person's physical health.

Cause is unknown but IBS is often associated with stress or anxiety and may follow severe infection of the intestine.

Tests may be carried out to eliminate specific organic diseases and possible causes of the symptoms.

Re. Effects/Symptoms:
There is no detectable structural disease but some symptoms may be due to

  • abnormal muscular contractions in the intestine.
  • heightened sensitivity to stimuli such as stretching or distension.

Treatment might involve:

  • reducing or removing anxiety (e.g. psychotherapy)
  • dietary adjustment
  • faecal softening agents
  • drugs to reduce spasm and / or reduce sensitivity to pain

Ulcer

An ulcer is a break in the skin that extends through all its layers, or a break in the membrane lining the alimentary tract that fails to heal and might also be inflamed.

See note for specific types of ulcers - below.

See note for specific types of ulcers - below.

An Aphtha is a small ulcer that occurs either singly or in groups in the mucous membrane of the mouth. Aphtha have the appearance of white or red spots, sometimes covered with a white or grey exudate.

There is no single disease known to cause aphthae (plural).

Factors associated with the occurrence of aphthae include:

  • stress
  • weakened immune system (due to stress, or for other reasons)
  • bacteria / viruses
  • allergies to any of a wide range of common foodstuffs, incl. e.g. coffee, chocolate, cheese, nuts, citrus fruits, potatoes.

The main effects of aphthae (plural) are pain and irritation at the site of the aphthae. This may be so severe that eating is uncomfortable, and so reduced, when aphthae are present in the mouth.

Aphthae sometimes affect other body tissues, including those of the GI tract and the external genitals.

If recurrent, scarring may occur.

Duodenal Ulcer

Duodenal ulcers are caused by the action of acid and pepsin on the duodenal lining (mucosa) of a susceptible person.

Duodenal ulcers are usually associated with an increased output of stomach acid.
The antrum of the stomach is almost always infected with helicobacter pylori.

Symptoms can include pain in the upper abdomen (especially when the stomach is empty), which may disappear for weeks or months. Vomiting can also occur.

Complications can include bleeding, perforation, and obstruction due to scarring.

Medical treatment might include the use of drugs to relieve the symptoms. Surgery is now only rarely necessary.

A Gastric Ulcer is an ulcer in the stomach.

Causes of gastric ulcers might include:

  • The action of acid, pepsin, and bile on the lining of the stomach (mucosa). However, the output of stomach acid is not usually increased.
  • Taking NSAIDs (non-steroid anti-inflammatory drugs) or corticosteroids may be pre-disposing factors.
  • helicobacter pylori is often present.
  • Symptoms can include vomiting and pain in the upper abdomen soon after eating.
  • Complications may include bleeding, perforation and obstruction due to scarring.
  • Medical treatment may include the use of antacids to relieve symptoms and / or anti-secretory drugs to heal the ulcer(s). Surgery is sometimes be recommended if the ulcer does not heal following initial treatment.
  • Gastric ulcers are usually examined using a gastroscope to confirm the diagnosis of a gastric ulcer, as opposed to other conditions such as stomach cancer.

A Peptic Ulcer is a breach in the lining (mucosa) of the digestive tract.

Peptic ulcers are caused by digestion of the mucosa by pepsin and acid. This may happen when pepsin and acid are present in abnormally high concentrations or when something else reduces the normal protective mechanisms of the mucosa. Bile salts may be involved, especially in cases of stomach ulcers.

A peptic ulcer can be found in:

There might not be any obvious symptoms, but many people experience abdominal pain - usually just below the sternum.

Effects / symptoms of a peptic ulcer can include:

  • abdominal pain - often just below the sternum (="breastbone"), can be a persistent burning pain that extends to he person's back.In some cases this pain may begin approx. 20 mins after eating, or it may awaken the person at night.
  • heartburn
  • regurgitating food
  • vomiting
  • bitter taste in the mouth

The conditions listed above are just a small group of digestive disorders - those considered most likely to be included in first level courses. To read about more diseases and disorders of the digestive system see the glossary category: Digestive Conditions.

See also causes of diarrhea.

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