Gastro Intestinal Tract

• The gastrointestinal (GI) tract is a series of hollow organs that form a long, twisting tube made up of the mouth (oral cavity), esophagus, stomach, small intestine, large intestine, and the anus.
• The liver, pancreas, and gallbladder are solid organ s that serve as the accessory organs of the digestive system.
• The small intestine is divided into three parts: the duodenum, jejunum, and ileum.
• The large intestine includes the appendix, cecum, colon, and rectum.
• The appendix is a finger-shaped pouch attached to the cecum, which is the first part of the large intestine.
• The cecum, colon, and rectum are parts of the large intestine.
• The digestive system has two main purposes: it breaks down food into simple substances that can be absorbed transported to all cells of the body and it eliminates solid remnants of food consumed, as well as excretion of some water.
• Diseases in the GI system usually result in signs and symptoms related to hemorrhage, motility, and perforation.
• Events/conditions that allow the virus excreted in the feces of infected people to reach drinking water supplies include war zones, and in camps for refugees or internally displaced populations (IDP).
• The clinical manifestations of hepatitis E virus (HEV) infection include an initial phase of mild fever, reduced appetite (anorexia), with occasional nausea and vomiting, lasting for a few days, some patients may complain of abdominal pain, skin rash, sometimes itchy but without skin lesions, jaundice (yellow discoloration of the skin and sclera), dark urine and pale stools, and slightly enlarged, tender liver (hepatomegaly).
• Preventive measures for HEV infection include washing and peeling all fresh fruits and vegetables, not eating raw or undercooked meat and fish, drinking boiled or bottled water and using it when brushing your teeth, avoiding all beverages of unknown purity, with or without ice, and if bottled water is not available, boiling tap water before drinking.
• A vaccine to prevent HEV infection has been developed and is licensed in China, but is not yet available in the Philippines at the time of writing.
• Gastrointestinal infections are among the most commonly encountered concerns in primary care.
• Gastrointestinal infections could be viral, bacterial, protozoal, or parasitic.
• Although gastrointestinal infections can be resolved in a few days, specific populations such as newborns, infants, the immunocompromised, and elderly patients are potentially at risk.
• Symptoms of gastrointestinal infections include diarrhea, vomiting, abdominal pain, and dehydration.
• Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus.
• Hepatitis A is characterized by inflammation of the liver that is not very severe and runs an acute course, generally starting within 2 to 6 weeks after contact with the virus.
• Hepatitis A is self-limiting and is the most benign and harmless type of hepatitis.
• The hepatitis A virus is one of several types of hepatitis viruses that cause inflammation and affect the liver’s ability to function.
• Hepatitis A is known as infectious hepatitis because it spreads relatively easily from those infected to those in close contact.
• The mean incubation period for hepatitis A is 30 days, with ranges from 15 – 60 days or 3 to 6 weeks.
• The infected patient is capable of transmitting the organism a week before and a week after the appearance of the symptoms.
• Mode of transmission for hepatitis A includes fecal-oral transmission, ingestion of contaminated food or water, from close contact with a person or object that is infected, eating raw shellfish harvested from water polluted with sewage, having oro-anal sex with someone who is infected with Hepatitis A, and sharing of needles between intravenous drug users.
• Clinical manifestations of hepatitis A infection typically do not appear until the person had the virus for a few weeks.
• Possible signs and symptoms of hepatitis A infection are fatigue, low-grade fever, anorexia, nausea and vomiting, abdominal pain or discomfort, especially on the upper right side beneath the ribs, clay-colored stools with dark urine, joint pain and/or arthralgia, yellowish discoloration of the skin and the sclera, and intense itching.
• HAV and HBV are diagnosed through complement fixation rate.
• Acute liver failure requires hospital confinement for monitoring and treatment.
• Troops living in crowded conditions at military camps or in the field are at risk of HAV infection.
• Administer alkalies, belladonna, and antiemetics to control dyspepsia and malaise in the management of hepatitis A.
• Travelling or working in areas of the world where hepatitis A is common increases the risk of HAV infection.
• In the fulminant type of hepatitis A, progressive hepatic encephalopathy characterized by drowsiness, cerebral edema may manifest.
• These older age groups account for the higher disease rates during outbreaks of the disease.
• Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and serum alanine transaminase (ALT) are part of the diagnostic procedures for hepatitis A.
• The hepatitis A vaccine can prevent infections and is typically given in two shots, the first one at age one year and the booster shot six months later.
• Infection rates are low in high-income countries with good sanitary and hygienic conditions.
• Sometimes spider nevi on the trunk are noted.
• Vitamin supplements, especially the B complex group, are recommended for managing hepatitis A.
• Intravenous therapy is occasionally necessary for managing hepatitis A.
• No specific treatment is prescribed for hepatitis A, although bed rest is essential.