Sunday, November 30, 2025

SERIES 3- GIT DISORDERS



Gastrointestinal Diseases 


1. Gastroesophageal Reflux Disease (GERD)

Early

  • Occasional retrosternal burning after meals
  • Sour taste in mouth
  • Worse on lying down

Progression

  • Frequent heartburn
  • Regurgitation of acidic fluid
  • Nocturnal cough / throat irritation

Advanced

  • Dysphagia (esophagitis, stricture)
  • Hoarseness
  • Dental enamel erosion

Classical Feature: Heartburn after meals + relief on antacids

Special: Symptoms worsen on bending forward (water brash)


2. Peptic Ulcer Disease (Gastric & Duodenal)

Early

  • Epigastric burning pain

Progression

  • Gastric ulcer: Pain worsens after meals
  • Duodenal ulcer: Pain relieved by meals, worsens 2–3 hours later

Advanced

  • Hematemesis, melena
  • Anemia

Special: Nocturnal pain common in duodenal ulcer


3. Acute Gastritis

Early

  • Epigastric discomfort
  • Nausea, bloating

Progression

  • Vomiting
  • Mild hematemesis

Advanced

  • Erosive gastritis → brisk bleeding

Classical: History of NSAID/alcohol use


4. Chronic Atrophic Gastritis

Early

  • Vague dyspepsia
  • Early satiety

Progression

  • Vitamin B12 deficiency → paresthesia
  • Fatigue (anemia)

Advanced

  • Achlorhydria

Special: Associated with autoimmune thyroid disease (Type A)


5. Acute Pancreatitis

Early

  • Acute severe epigastric pain radiating to back

Progression

  • Vomiting
  • Fever
  • Abdominal distension

Advanced

  • Hypotension, shock
  • Grey-Turner & Cullen signs

Peculiar: Pain relieved by leaning forward


6. Chronic Pancreatitis

Early

  • Recurrent epigastric pain

Progression

  • Steatorrhea
  • Weight loss

Advanced

  • Diabetes mellitus (pancreatic)

Classical: Calcifications on imaging


7. Acute Appendicitis

Early

  • Periumbilical pain

Progression

  • RLQ pain (McBurney’s point)
  • Fever, vomiting

Advanced

  • Guarding, rebound tenderness
  • Perforation → generalized peritonitis

Special: Rovsing, Psoas, Obturator signs


8. Irritable Bowel Syndrome (IBS)

Early

  • Recurrent abdominal pain

Progression

  • Altered bowel habits (constipation/diarrhea)
  • Bloating

Advanced

  • Mucus in stools
  • Relief of pain after defecation

Special: No red-flag signs (weight loss, fever)


9. Inflammatory Bowel Disease (Ulcerative Colitis)

Early

  • Bloody diarrhea

Progression

  • Tenesmus
  • Lower abdominal pain

Advanced

  • Weight loss
  • Extra-intestinal features (uveitis, arthritis)

Classic: Continuous lesion from rectum


10. Crohn's Disease

Early

  • Intermittent abdominal pain

Progression

  • Chronic diarrhea (non-bloody early)
  • Weight loss

Advanced

  • Perianal fistula
  • Malabsorption

Classical: Skip lesions + cobblestone mucosa


11. Acute Cholecystitis

Early

  • RUQ pain

Progression

  • Fever
  • Vomiting

Advanced

  • Murphy's sign positive
  • Empyema / perforation

Special: Pain after fatty meals


12. Chronic Cholecystitis

Early

  • Recurrent RUQ discomfort

Progression

  • Bloating, indigestion

Advanced

  • Porcelain gallbladder

Classical: History of repeated gallstone attacks


13. Cholangitis (Ascending)

Early

  • Fever + RUQ pain

Progression

  • Jaundice

Advanced

  • Hypotension + Confusion (Reynold's pentad)

Classic: Charcot’s triad

Special: Rapid deterioration


14. Hepatitis A/B/C (Acute Viral Hepatitis)

Early

  • Fatigue
  • Nausea
  • Anorexia

Progression

  • Jaundice
  • Dark urine, pale stools
  • RUQ discomfort

Advanced

  • Coagulopathy

Classical: ALT/AST > 10x normal


15. Cirrhosis (Any Etiology)

Early

  • Fatigue, anorexia

Progression

  • Jaundice
  • Ascites
  • Edema

Advanced

  • Hepatic encephalopathy
  • Variceal bleeding

Special: Spider nevi + palmar erythema


16. Portal Hypertension

Early

  • Splenomegaly

Progression

  • Ascites

Advanced

  • Esophageal varices
  • Caput medusae

Special: Hematemesis from variceal rupture


17. Gastroenteritis (Infective)

Early

  • Nausea
  • Vomiting

Progression

  • Diarrhea
  • Abdominal cramps

Advanced

  • Dehydration
  • Electrolyte imbalance

Classical: History of contaminated food/water


18. Colorectal Cancer

Early

  • Change in bowel habits

Progression

  • Occult GI bleeding → iron deficiency anemia

Advanced

  • Weight loss
  • Obstructive symptoms

Left-sided: Constipation + pencil-thin stool

Right-sided: Occult bleeding + anemia


19. Celiac Disease

Early

  • Diarrhea
  • Bloating

Progression

  • Steatorrhea
  • Weight loss

Advanced

  • Dermatitis herpetiformis

Special: Symptoms resolve on gluten-free diet


20. Intestinal Obstruction

Early

  • Colicky abdominal pain

Progression

  • Vomiting
  • Distension

Advanced

  • Obstipation
  • Dehydration

Classical: High-pitched tinkling bowel sounds



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SERIES 3- GIT DISORDERS

✅ Gastrointestinal Diseases  1. Gastroesophageal Reflux Disease (GERD) Early Occasional retrosternal burning after meals Sour taste ...