GASTRO INTESTINAL DISORDERS

Dr.linda maher

GIT(GASTRO INESTINAL TRACT)

it is a tube with muscle walls throughout its length. it is lined by an epithelium. The salivary glands , liver and pancreas pour their secretions into the gut lumen

:FUNCTIONS OF GIT.

1\MOTILITY: mixing and propelling the food along the tract

2\DIGESTION: the process of secreting enzymes which break down the complex food materials into simple forms

3\ABSORBTION: conveying the end products of digestion to the bloodstream

GIT DISORDERS

Though the mouth is the entry of GIT ,few GIT diseases directly affect the oral cavity.

Usually the lesions are secondary lesions which may be induced by factors such as malabsorption.

1\CELIAC DISEASE(gluten sensitive enteropathy)

Celiac disease is a permanent intolerance to gluten(the protein component of wheat)

AETIOLOGY: malabsorption of gluten due to

morphological abnormalities in the small intestinal mucosa(GENETICAL ABNORMALITIES)

CLINICAL FEATURES: diarrhea , weight loss ,skin rash and

blisters

.

ORAL MANIFISTATIONS: Malabsorption may lead to hematinic

deficiencies (iron,folate ) causing recurrent Aphthus Ulcers and glossitis

DIAGNOSIS: Biopsy of the small intestine Blood investigations TREATMENT: 1\correct iron , folate and b12 deficiencies 2\gluten free diet

2\INFLAMMATORY BOWL DISEASE

inflammatory bowel diseases are lifelong conditions resulting from aberrant inflammation of the mucosal lining of the gastrointestinal tract

Two forms: 1\ Crohn's disease, which may affect the

gut anywhere, mainly the ileocaecal region .

2\ulcerative colitis, which is predominantly within the colon.

A\CRHON’S DISEASE

Gastro intestinal inflammatory disease that affects mainly the ileocaecal region causing thickening and ulcerations

AETIOLOGY: Unknown CLINICAL FEATURES: Abdominal pain, variable constipation or diarrhea

, obstructions and malabsorption may occur . fistula Joint pain

.

Orofacial manifestations: 1\Diffuse soft swelling of the lips 2\cobblestone thickening of the buccal

mucosa with fissuring and hyperplastic folds 3\gingiva may be swollen and erythematous 4\some times painful mucosal ulcerations 5\glossitis due to iron, folate , or vitamin b12

deficiency can result from malabsorption

.

TREATMENT: 1\corticosteroids 2\sulfasalazine(anti inflammatory) 3\in very severe cases surgery may be

indicated

B\ULCERATIVE COLITIS

The inflammation in ulcerative colitis may affect all or part of the large intestine

AETIOLOGY: Unknown CLINICAL FEATURES: Rectal bleeding and diarrhea Cramps and severe pain red swollen nodules that are usually on the

thighs and legs, may be present. Anemia

.

ORAL MANIFISTATIONS: oral changes that occur in ulcerative colitis

cases are nonspecific and uncommon, with an incidence of less than 8%.

Uphthus ulcer may occur in patients with ulcerative colitis may result from nutritional deficiencies of iron, folic acid, and vitamin B12 due to poor absorption in the gut and/or blood loss directly related to the ulcerative colitis

.

DIAGNOSIS: is made on the basis of careful history,

physical examination, gastrointestinal radiography, and endoscopy.

TREATMENT: Sulfasalazine

3\OROFACIAL GRANULOMATOSIS

Clinically and histologically identical to crohn’s disease

DIAGNOSIS: By exclusion of crohn’s disease,

sarcoidosis AETIOLOGY: Probable cause is a hypersensitivity

reaction to certain foods

.

TREATMENT: 1\identify and avoid the irritant factor 2\intralesional steroids

4\GASTROEOSOPHAGEAL REFLUX

Gastro esophageal reflux disease (GERD) is one of the most commonly occurring diseases affecting the upper gastrointestinal tract

During gastro esophageal reflux, gastric contents passively move up from the stomach into the esophagus causing damage to the esophageal mucosa

AETIOLOGY: lower esophageal sphincter incompetence

(unknown cause)

.

CLINICAL FEATURES: Heartburn is the cardinal symptom of GERD and

is defined as a sensation of burning or heat that spreads upward from the epigastria to the neck.

Esophageal ulcerations ORAL MANIFISTATIONS: dysgeusia(bad taste), dental sensitivity related to hot or cold stimuli, dental erosion, and/or pulpitis( erosion of

enamel by gastric acid especially the palatal aspect of teeth)

.

MANAGEMENT: Significant success in preventing or reducing

the symptoms seen with lifestyle modification Weight loss (reduces the pressure difference

between the abdomen and thorax) Less fatty meal (fatty meal slow down gastric

emptying and increase the reflux symptoms) Sleeping with the head of the bed elevated Simple antacids(e.g. proton pump inhibitor-H2

receptor antagonist)

.

THANK YOU