Upper Gi Bleeding

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Case Study 1 NURS7702
During the course of gastrointestinal disorder, different patients with different diagnosis have similar symptoms. To understand the different pathophysiology in this case scenario, possible medical diagnosis of Mrs. M. symptoms will be defined to distinguish the difference of each one. Mrs. M symptoms could lead to several possible gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, coeliac disease and may be tropical sprue or parasitic disorder. The physician diagnosed and treated Mrs. M with irritable bowel syndrome probably because of the common symptoms of the gastrointestinal disorders she had experienced such as chronic diarrhoea, abdominal distention, increased flatulence, and abdominal cramps. Irritable bowel syndrome (IBS), can be defined as a combination of abdominal pain or discomfort and altered bowel habit. The alteration in bowel habit can take the form of altered stool frequency (ie, diarrhoea or constipation) or altered stool form in terms of thin, overly hard and firm, or soft (and even liquid) stools. Symptoms that are commonly associated with IBS include passage of clear or white mucus with a bowel movement, sensation of incomplete evacuation after having a bowel movement, and relief of abdominal pain or discomfort transiently after defaecation and abdominal bloating. However, weight loss, hypoalbuminemia and being anaemic not usually seen in IBS patients. | |

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The symptoms of inflammatory bowel disease could also cause Mrs. M symptoms. The term inflammatory bowel disease (IBD) is ulcerative colitis and Crohn's disease. Because the two signs and symptoms are very similar, distinguishing the two diseases can be difficult. The only definitive two forms between the two are:- ulcerative colitis only affects the colon whereas the crohns disease mostly often occurs the terminal ileum and anywhere in the GI tract. These can also be confirmed by obtaining histology for definite confirmation of the disease. Ulcerative colitis is characterized by recurring episodes of inflammation of the mucosal layer of the large bowel not related to an intestinal infection or nonsteroidal anti-inflammatory drug (NSAID) use. The inflammation involves the rectum and may extend proximally in a continuous fashion. Crohn's disease is characterized by recurring episodes of inflammation of any part of the bowel, from the mouth to the anus. This inflammation is transmural, and can result in strictures, microperforations, and fistulae. The inflammation is noncontiguous and thus can produce skip lesions throughout the bowel. Histologically, Crohn's disease can have either transmural lymphoid aggregates or non-necrotizing granulomas. Although granulomas are pathognomonic, they are seen in only 10% of patients with Crohn's disease (Lashner, 2009). Other symptoms that may lead to Mrs. M’s chronic diarrhoea, weight loss and abdominal distention could be a parasitic infestation. Certain parasites, primarily protozoa, produce a prostaglandin (hormone like substances found in various human tissues) which creates a sodium and chloride loss that leads to frequent watery stools. Coping with a parasitic disease can be stressful, more so when the patient believes that parasites come from being dirty. Parasites can be contracted regardless of the cleanliness of the home. While hand washing and overall cleanliness are positive ways to prevent parasitic infections and diseases, but there’s no guarantee that parasites won’t infect other member of the family. Other possible medical diagnosis of Mrs. M’s symptoms could include chronic pancreatitis, although the symptoms of this illness vary greatly among patients. The symptoms of chronic pancreatitis are often an indication of many gastrointestinal diseases, most patients who have chronic pancreatitis have decreased appetite, and thus, patient develops weight loss. The pancreas...
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