Patients with gastrointestinal and hepatobiliary disorders often face life-altering changes, including changes to diet, new treatment regimens, and more. For some disorders, treatments can include surgery.

Gastrointestinal conditions, such as ulcers, diverticulitis, and pancreatitis, often cause varying levels of pain and discomfort. Hepatobiliary conditions can also bring significant changes to patient routines and well-being.

Examine fundamental concepts of gastrointestinal and hepatobiliary disorders. You explore common disorders in these categories, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

THE QUESTION

In this exercise, you will complete a 5-essay type question 

QUESTION 1

1.
Scenario 1: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.  

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis, 

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain 

Family Hx-non contributary  

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.  

Breath test in the office revealed + urease. 

The healthcare provider suspects the client has peptic ulcer disease.

Questions:

1.     Explain what contributed to the development from this patient’s history of PUD?


Scenario 1: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.  

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis, 

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain 

Family Hx-non contributary  

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.  

Breath test in the office revealed + urease. 

The healthcare provider suspects the client has peptic ulcer disease.

Question:

1.     What is the pathophysiology of PUD/ formation of peptic ulcers? 

QUESTION 3

1.
Scenario 2: Gastroesophageal Reflux Disease (GERD)

A 44-year-old morbidly obese female comes to the clinic complaining of  “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get wor