DIGESTIVE SYSTEM TERMS

Gastroesophageal Reflux Disease (GERD) –Severe “heartburn” in laymen’s language. Weakness of the valve between the esophagus and stomach may allow stomach acid to reflux (regurgitate, backup) into the esophagus and irritate and inflame the lining. This results in chest pain which can mimic that of angina (pain of cardiac ischemia or an MI).

Jaundice – Literally means “yellow” in French. Yellowing of the skin and whites of the eyes from a backup of bile metabolic by-products from the blood into body tissues. May result from blockage of the ducts draining bile from the liver into the intestines or excessive breakdown of red blood cells. Hemoglobin from destroyed RBCs is broken down, and in part, ends up in bile secretions.

Diverticulosis/diverticulitis – Small pouches may form along the walls of the large intestine called diverticuli which if symptomatic, causing discomfort to the patient, is called diverticulosis. These abnormal outpocketings may collect and not be able to empty fecal material which can lead to inflammation, diverticulitis.

Cirrhosis – Literally, “orange-yellow” in Greek. A degenerative disease of the liver that often develops in chronic alcoholics, but can have other causes. The name refers to the gross appearance of the organ.

Portal hypertension – A potential complication of chronic alcoholism resulting in liver damage and obstruction of venous blood flow through the liver. The rising blood pressure in the veins between the gastrointestinal tract and liver causes engorgement of veins around the umbilicus (navel). The characteristic radiating pattern of veins is called a “caput medusae” (head of Medusa). Medusa was the “snake-haired lady” in Greek mythology.

Esophageal varices – bulging, engorged veins in the walls of the esophagus are often a complication of chronic alcoholism (see portal hypertension). The thin-walled, swollen veins are at risk of tearing resulting in severe, possibly fatal, bleeding.

Dysphagia – Difficulty swallowing. May be related to GERD (see above), esophageal tumor or other causes.

Crohn’s Disease – a chronic inflammatory disease primarily of the bowel. Typical symptoms are abdominal pain, weight loss, diarrhea. There may also be rectal bleeding that can lead to anemia. Special X-rays and tests are needed to differentiate Crohn’s from other diseases with similar symptoms.

Peritonitis – Inflammation of the lining of the abdominal cavity. Before antibiotics, people would die from peritonitis if an inflamed appendix burst. Indications of peritonitis are called “peritoneal signs”: tender abdomen, rebound pain (pain when manual pressure released from examining abdomen), board-like rigidity of abdominal muscles, no bowel sounds (gurgles). The peritoneal membrane is very sensitive to exposure to foreign substances. Contact with blood, bile, urine, pus will cause peritoneal signs.

Digestive system procedures/specialists

Gastroenterologist – a physician specializing in diseases of the digestive system including esophagus, stomach and intestines. These specialists do not do surgery. Patients needing surgery are referred to a general surgeon.

Proctologist – a physician specializing in diseases of the rectum and anus. Proctology is a surgical subspecialty.

Guaiac test (Hemoccult, Fecult) – a special chemical test to identify blood in the stool (feces). Blood in the stool may have many causes including cancer and hemorrhoids.

Upper GI series – a series of X-rays of the esophagus and stomach and small intestines having the patient swallow a “milkshake” of barium. The element barium is opaque, i.e. blocks , X-rays. This procedure may be used to identify problems with swallowing, stomach ulcers, twisting of the small intestines.

Lower GI series – a series of X-rays using a barium enema to show the large intestine and rectum. This procedure can be used to identify problems such as diverticulitis/diverticulosis, and tumors.

Endoscopy – use of a flexible fiberoptic instrument attached to a video camera that can be used to directly visualize the esophagus, stomach and large bowel. Special names may be used for each area explored such as colonoscopy.

Ultrasonography (ultrasound) – a procedure using high frequency sound waves to visualize internal organs. Primarily used to visualize abdominal and pelvic organs, such as the pregnant uterus.

Digestive system medical record

You should be getting pretty good at making sense of medical terminology. But, nothing beats practical application! Following is an abstract of a simulated patient’s medical record. Note words in italics. Take them apart. Look for the “root” meaning. Read the record and answer the questions that follow to yourself. If you can’t think of the meaning, hover your cursor over the word for a tip.

A 48 year old male complains of abdominal discomfort after meals, especially, high fat meals. At those times he also has aching in his right shoulder and back. An  ultrasound of the upper abdomen revealed cholelithiasis. A consult with a gastroenterologist determined that cholelithotripsy was considered but it was decided that a laparoscopic cholecystectomy would be the first procedure attempted. If complications were encountered then an open cholecystectomy would be performed.

Significant medical history: patient had a coronary angiography performed at age 46 following suspected myocardial infarct.

• What is the diagnosis (the patient’s current medical problem)?

• Did the procedure performed to aid in the diagnosis involve use of X-rays?

• Was a specialist appropriate to the diagnosis consulted?

• What treatments were considered?

• What significant event was in the patient’s medical history?

• What procedure was performed in the patient’s medical history?

IN PLAIN ENGLISH

A 48-year-old male complains of abdominal discomfort after meals, especially, high fat meals. At those times he also has aching in his right shoulder and back. A procedure using high frequency sound waves to image the upper abdomen revealed stones in the gallbladder. A consult with a specialist in diseases of the digestive tract determined that crushing the gallbladder stones with sound waves was considered but it was decided that a removal of the gallbladder using a scope and instruments inserted into the abdominal wall would be the first procedure attempted. If complications were encountered then opening up the abdomen and removing the gallbladder would be performed.

Significant medical history: The patient had a heart attack. The patient’s heart arteries were imaged by injecting a dye opaque to X-rays into an artery to show area of blockage of blood flow to heart muscle.

Surprised at how much you understood? I’m not!

Before taking the quiz, you may want to check back to “Basics” and review the word stems for mouth, tongue, gums, stomach, small and large intestines and liver.

Please go the next page:http://medenglishedu.com/index.php?c=content&a=show&id=523 to check your understanding.