Gastrointestinal disease

Lore & Background

The gastrointestinal tract is a continuous system that begins at the oral cavity and ends at the anus. Oral diseases, such as gingivitis and periodontitis, are the most common GI conditions and can signal systemic or other GI diseases. These oral manifestations often mirror lesions elsewhere in the digestive tract, presenting with swelling, inflammation, ulcers, and fissures; their presence increases the likelihood of anal and esophageal lesions. Gastroesophageal reflux disease is the most common esophageal condition in Western countries, and chronic forms may lead to Barrett's esophagus, a change in the esophageal epithelium. Acute esophageal disorders include infections, trauma from corrosive substances, or ruptured veins such as esophageal varices, Boerhaave syndrome, or Mallory-Weiss tears. Chronic esophageal diseases encompass congenital conditions like Zenker's diverticulum, esophageal webbing, and motility disorders including achalasia, nutcracker esophagus, and diffuse esophageal spasm. Gastric diseases include gastritis, which when chronic is associated with atrophic gastritis, pyloric stenosis, and gastric cancer. Peptic ulcers, most commonly caused by Helicobacter pylori, erode the gastric mucosa. Vomiting blood may also result from ruptured abnormal arteries or veins, such as Dieulafoy's lesion or gastric antral vascular ectasia. Congenital gastric disorders include pernicious anemia, where an immune response against parietal cells prevents vitamin B12 absorption. Intestinal diseases affect the small and large bowels, with inflammation called enterocolitis often causing diarrhea. Acute conditions include infectious diarrhea and mesenteric ischemia. Constipation may arise from faecal impaction or bowel obstruction caused by ileus, intussusception, or volvulus. Inflammatory bowel disease, of unknown cause, is classified as Crohn's disease or ulcerative colitis. The normal small intestinal wall thickness is 3–5 mm, and 1–5 mm in the large intestine; focal, irregular thickening on CT suggests malignancy, while segmental or diffuse thickening typically indicates ischemic, inflammatory, or infectious disease. Small intestine diseases include malabsorption disorders such as coeliac disease, tropical sprue, and short bowel syndrome, as well as rarer conditions like Curling's ulcer, blind loop syndrome, and Whipple's disease.

Reader's Guide

Gastrointestinal diseases represent a major category of human illness, affecting millions worldwide. Common oral diseases like dental caries and periodontitis are plaque-induced, while esophageal diseases range from reflux to motility disorders. Gastric ulcers and cancer are significant, with H. pylori infection a key cause. Intestinal diseases include infectious diarrhea, inflammatory bowel disease (Crohn's disease and ulcerative colitis), and malabsorption disorders like coeliac disease. Large intestine conditions such as appendicitis, diverticulitis, and irritable bowel syndrome are prevalent. Rectal and anal diseases, including hemorrhoids and anal fissures, are extremely common in older adults. Hepatic diseases, such as hepatitis, affect the liver. The article emphasizes that many GI diseases can manifest with oral symptoms, and diagnostic tools include endoscopy, colonoscopy, barium studies, and stool analysis. Understanding these diseases is crucial for diagnosis and treatment, as they can cause symptoms like vomiting, diarrhea, constipation, bleeding, and malnutrition.

Did You Know?

• Gastroesophageal reflux disease can cause acid erosion of the teeth and halitosis.
• Hemorrhoids and pruritus ani are very common conditions affecting the rectum and anus, especially in older adults.