George was morbidly obese and had frequent heartburn, for which he was prescribe
ID: 3517452 • Letter: G
Question
George was morbidly obese and had frequent heartburn, for which he was prescribed omeprazole. Before undergoing a vertical sleeve gastrectomy, he had an endoscopy that revealed Barrett's esophagus. A year after his successful bariatric surgery, he suffered abdominal pain with alternating periods of diarrhea and constipation, although a colonoscopy uncovered no structural reason for his symptoms. The pain disappeared, but months later a different abdominal pain began, and his eyes appeared yellowed. An ultrasound revealed that he had gallstones, and laboratory tests showed elevated plasma levels of amylase and lipase. George was hospitalized and treated for pancreatitis, and afterward underwent a cholecystectomy that resolved his pain.
Some of the new terms and concepts you will encounter include:
Barrett's esophagus, GERD, bariatric surgery, and proton pump inhibitors
Bilirubin, jaundice, pancreatic juice enzymes, intestinal microbiota
George suffered heartburn and was diagnosed with Barrett's esophagus.
What is heartburn and what causes it?
What is Barrett's esophagus and what causes it?
George had a vertical sleeve gastrectomy.
What kind of surgery is this, and what can it accomplish?
How can George still digest and absorb food after this procedure?
George had a prescription for omeprazole.
What kind of a drug is omeprazole, and what is its action?
Which of George's conditions does this drug treat?
How might George's bariatric surgery help reduce his need for this drug?
George had abdominal pain with alternating diarrhea and constipation, but no abnormal findings from his colonoscopy.
What is IBD, and might George have had it?
What is IBS, and might George have had it?
George's eyes appeared yellow when he went for an abdominal ultrasound.
How was the yellowing of his sclera produced?
How would his ultrasound results explain the yellowing of George's eyes?
George was obese and lost weight rapidly as a result of his bariatric surgery, making him more susceptible to developing gallstones.
What are gallstones, and how are they produced?
How do gallstones account for George's symptoms?
George was hospitalized with pancreatitis after getting his test results.
What tests indicated that he had pancreatitis?
What type of pancreatitis did George have, and what probably caused it?
Explanation / Answer
HEARTBURN AND CAUSES:
it's a symptoms of gastroesophageal reflux disease. due to acid production in the stomach.
BARRETTS OESOPHAGUS AND CAISES;
metaplasia in the lower end of oesophagus. and there is oesohoesohageal adenocarcinoma. and premalignant condition.
causes;
long term acid exposure. and those with gastroesophageal reflux disease.
VERTICAL SLEEVE GASTRECTOMY;
surgical removal of stomach by as much as 15% along the greater curvature.
and is irreversible.
DIGESTION OF FOOD;
food quantity is reduced by large. little amount of food at short intervals taken . chews well.
OMEPRAZOLE AND MECHANISM OF ACTION;
for treatment of gastroesophageal reflux disease and peptic ulcer disease. taken orally and intravenously. selectively and irreversible proton pump inhibitor. suppressed acid secretion .
IBD;
Inflammatory bowel disease are conditions of colon and small intestine.
ulcerative colitis and corhns disease.
can also affect mouth s and intestines.
IBS;
Irritable bowel syndrome includes abdominal pain and patterns of bowel movements causing pain without any evidence of damage.
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