The Gastrointestinal System Discussion Paper
The Gastrointestinal System Discussion Paper
Module 5 – The Gastrointestinal System
After completing Module 5 in Shadow Health, discuss two key gastrointestinal alterations (such as Irritable Bowel Syndrome or Crohn’s Disease – there are several mentioned in the Shadow Health module) and how the pathophysiologic changes will affect daily life for these patients. This will need to include a brief discussion of the pathophysiology leading to the effects on daily life.
Directions:
The assignment should be at least 2 and no more than 3 pages. The idea is to concisely convey your thoughts.
Include one scholarly source within 5 years of publication pertaining to the topic that adds additional content or support of the topic The Gastrointestinal System Discussion Paper
Include an APA formatted reference at the conclusion of the paper
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Irritable bowel syndrome
The disease is defined as a chronic gastrointestinal disease that presents with abdominal discomfort or pain with alteration of the bowel habits in the absence of other causative agents. The pathophysiology is not well understood however mechanisms such as alterations involving brain-gut interaction, motility, visceral sensation and psychosocial distress have been proposed to explain the disease process (Patel & Shackelford, 2022). Environmental contributors of the disease include; food intolerance, early life stressors, enteric infections and antibiotic use.
Serotonin dysregulation
Research studies have shown that serotonin hormone acting through the 5-HT3
and 5-HT4
Receptors play a fundamental role in the GIT motility, sensation and secretion. There are clinical evidences that show that the plasma serotonin concentrations are decreased in IBS patients with constipation, but increased in those with diarrhoea, therefore providing further support for the sensory and motor dysfunction associated with the condition The Gastrointestinal System Discussion Paper.
Infection and immune activation in IBS
According to Ford et al., (2020), there is a close association between immune activation and the etiology of IBS. It is believed that approximately one in ten patients with IBS started with an infectious illness. Persistent exposure to intestinal infections results in systemic and mucosal inflammation that is characterized by mucosal infiltration of immune cells, changes in the population of circulating and increased production of cytokines. This consequently leads to changes in the GIT microbiota, mucosal immunocytes, enteric nerves, enterochromaffin and mast cells. Psychological stressors have been reported to cause immune activation.
Bacterial overgrowth
Research studies have shown that small intestinal bacterial overgrowth is common in IBS patients as it contributes to some of the symptoms. However, it is important to note that there are interactions with other causative agents.
Psychosocial distress
Psychosocial factors are fundamental in IBS. Depression and anxiety are commonly associated with IBS. For instance, there is evidence that shows that childhood or adulthood abuse is associated with IBS.
Central dysregulation and brain-gut interaction
The CNS regulates different functions such as secretion, motility and blood flow. The signals from the gut in turn regulates the reflexes (Ford et al., 2020)The Gastrointestinal System Discussion Paper. A disordered communication within the brain-gut is associated with the development of the disease.
How IBS affects the daily life of patients
While IBS is not a life-threatening disease, it is a burden and acts as a hindrance to a patient’s sense of well-being and daily routine. It affects the quality of life, if the affected patients cannot find a suitable menu at a restaurant or an accessible toilet to relieve the symptoms. The symptoms are also associated with poor work productivity and increased work absenteeism because of the symptoms.
Crohn’s disease
Crohns disease is a chronic relapsing inflammatory disease that is characterized by a transmural granulomatous inflammation that affects any part of the GIT, most commonly the colon, ileum or both. The clinical manifestations consists; chronic diarrhoea which can be mucoid, bloody or both, abdominal pain (right lower quadrant), bloating, fever and weight loss. Extra intestinal manifestations include; uveitis, episcleritis, stomatitis and others.
The intestinal immune system is important in the disease development. Normally, the intestinal epithelium hinders antigen or bacteria entry into the circulation by sealed intercellular junction. In crohn’s disease, these junctions are defective due to primary barrier function failure or as a result of severe inflammation (Feuerstein & Cheifetz, 2017). Tissue inflammation is as a result of uncontrollable immune response against the luminal bacterial antigens.
The immune cells that are involved in the inflammatory process in crohn’s disease patients include; CD4 T-cells, CD8 T-cells, CD14 monocytes, B-cells and natural killer cells. One of the immune-mediated susceptibility to crohn’s disease is due to the innate mechanism of defense from infectious diseases and an example is the intestinal mucus secretion. Excessive inflammatory processes causes continued decrease in function of the epithelium and further exposure of the intestinal microbes thus further worsening the inflammation (Ballester Ferré et al., 2018)The Gastrointestinal System Discussion Paper. Some of the factors associated with the increased risk of crohn’s disease include; smoking, high dietary intake of fats, meat, use of oral contraceptives and genetic predisposition.
How crohn’s affects the daily life of patients
The disease significantly affects the daily life of the affected including; education, work and social relationships. During the flares patients tend to report of general body weakness, fatigue and abdominal pain which diminishes their quality of life and overall performance. Adults who experience weight loss may have body-image problems whereas children may experience a delay in development.
References
Ballester Ferré, M. P., Boscá-Watts, M. M., & Mínguez Pérez, M. (2018). Enfermedad de Crohn. Medicina Clínica, 151(1), 26–33. https://doi.org/10.1016/j.medcli.2017.10.036
Feuerstein, J. D., & Cheifetz, A. S. (2017). Crohn Disease: Epidemiology, Diagnosis, and Management. Mayo Clinic Proceedings, 92(7), 1088–1103. https://doi.org/10.1016/j.mayocp.2017.04.010
Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020). Irritable bowel syndrome. The Lancet, 396(10263), 1675–1688. https://doi.org/10.1016/s0140-6736(20)31548-8
Patel, N., & Shackelford, K. (2022, July 4). Irritable Bowel Syndrome. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534810/
Weaver, K. R., Melkus, G. D., & Henderson, W. A. (2017). Irritable Bowel Syndrome. AJN, American Journal of Nursing, 117(6), 48–55. https://doi.org/10.1097/01.naj.0000520253.57459.01 The Gastrointestinal System Discussion Paper
Key gastrointestinal alterations
Introduction
Gastrointestinal alterations refer to abnormalities in the neurons and structures of the gastrointestinal tract and finally slow down, obstruct, or accelerate the movement of intestinal materials (Grady, 2021). Several gastrointestinal alterations include irritable bowel syndrome(IBS), constipation, Crohn’s Disease, food poisoning, bloating, nausea, gas, diarrhea, and GERD. This paper discusses irritable bowel syndrome and GERD Disease, the gastrointestinal alterations.
Etiology and epidemiology of IBS
IBS is a digestive system disorder that affects the stomach and the intestines and is one of the most commonly treated intestinal diseases. It is the presence of abdominal discomfort or pain, including altered bowel habits. It has a broad etiology not known, although its development is usually linked to visceral sensation, motility, psychological distress, and brain-gut interactions (Black & Ford, 2020)The Gastrointestinal System Discussion Paper. The prevalence of IBS range between eleven to sixteen percent, but most patients do not seek medical attention in the united states and Canada. Diarrhea is common in men, while women mostly report abdominal pains and constipation, decreasing with age. Specific diagnosis is used for each of these, including IBS with constipation (IBS-C) and IBS with diarrhea (IBS-D) which differs in Europe versus the united states.
Pathophysiology and Histopathology of IBS
IBS has broad pathophysiology, including psychological distress, motility, and brain-gut interaction, although not all these symptoms are attributed to all IBS patients (Lavelle & Sokol, 2020). IBS is also associated with intestinal and colonic microbiomes. There is an environmental cause of IBS, such as antibiotics, early life stressors, enteric infections, and food intolerance. After a histopathology examination of the intestinal mucosa, most patients show mast cells, chronic inflammatory cells, enteric nerves, and enteroendocrine cells (Black & Ford, 2020).
Gastroesophageal reflux disease (GERD)
This condition occurs when the stomach content flows back into the esophagus or regurgitation. It is a common digestive disorder with a prevalence in north America of 18.1-27.8% (Antunes et al., 2022)The Gastrointestinal System Discussion Paper. GERD is characterized by troublesome complications and symptoms caused by the reflux of stomach content into the esophagus. The most common symptom of GERD is heartburn, a burning sensation in the chest associated with a sour taste.
Epidemiology and Pathophysiology of GERD
The risk factors associated with GERD include smoking, excessive body mass, less physical activity, anxiety, and eating habits such as the timing of meals. Although this is a lower esophageal sphincter disorder, pathologic and physiologic factors contribute to its development. Transient lower esophageal sphincter relaxations are the primary cause of GERD. Other causes include impaired esophageal clearance, delayed gastric emptying, and Hiatal hernias (Antunes et al., 2022). The regurgitation and heartburn cause discomfort, thus affecting the productivity of the victims.
Summary
Irritable bowel syndrome (IBS) and GERD are common gastrointestinal alterations. GERD is a common problem characterized by significant morbidity and decreased life quality (Grady, 2021). The complications are prevented through early recognition of the symptoms of both conditions. The treatment of GERD mainly involves acid suppression and behavioral changes. Stopping or reducing the consumption of FODMAPs is also effective in treating and preventing IBS.
Conclusion
In conclusion, gastrointestinal alterations such as irritable bowel syndrome and Gastroesophageal reflux disease significantly reduce people’s economic productivity. The discomfort associated with these two disorders leads to anxiety or depression and sometimes embarrassment resulting from diarrhea. The conditions can be treated through lifestyle modification and medical and surgical therapies in critical conditions. The Gastrointestinal System Discussion Paper
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References
Antunes, C., Aleem, A., & Curtis, S. A. (2022). Gastroesophageal Reflux Disease. In StatPearls. StatPearls Publishing.
Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: trends, predictions, and risk factors. Nature reviews Gastroenterology & hepatology, 17(8), 473–486.
Grady, W. M. (2021). Epigenetic alterations in the gastrointestinal tract: current and emerging use for cancer biomarkers. Advances in Cancer Research, pp. 151, 425–468.
Lavelle, A., & Sokol, H. (2020). Gut microbiota-derived metabolites as critical actors in inflammatory bowel disease. Nature reviews Gastroenterology & hepatology, 17(4), 223-237.
The Gastrointestinal System Discussion Paper