GIT

Lecture11:
Gastrointestinal tract
Symptoms of gastrointestinal disorder are common in the general population and some, such as indigestion and difficulty in swallowing, can be related to patients to poor dental health.

Dysphagia:
is the term used for difficulty in swallowing, it begin at initiation of swallowing , it is painful and described by sensation of food stuck.
Odynophagia:
is the term used for pain of swallowing.
Causes:
1-Stricture(obstruction of esophagus).
2-Chemical burn. 3-Tonsilitis. 4-Achalasia spasm(closure of gastro-esophagus junction).
5-Pharyngeal pouch. 6-Pulmer-Vinson syndrome(iron deficiency anemia, associated with post-cricoid carcinoma lead to oral leukoplakia).

Gastric acid reflux: It is back ward of acid from stomach to esophagus.
Causes:
1-heatus hernia: weakening in the muscles of gastro-esophageal junction that allow the stomach to herniated through diaphragm in the chest cavity.
2-Pregnant women.
1- Obesity, smoking and alcoholism.
4-Habitual(bolemia).
Treatment:

patient must be treated with anti-acid to avoid enamel erosion and oral ulceration.

Celiac disease:
genetic hypersensitivity or toxic reaction of small intestine mucosa to the gliadin group of gluten which found in all types of wheat and other grains and causes destruction of villi, it affect the Caucasian people and rarely affect Chinese and Jupanese.
Symptoms:

1-diarrhea.

2- malabsorption syndrome.

3-abdominal pain.

4-anemia due to iron deficiency.

5-bleeding due to vitamin k defficincy.

6-Titany and muscle weakness due to vitamin D defficincy.
Oral manifestation:
1-oral ulceration. 2-dermatitis. 3-angular stomatitis. 4-deposition of IgA with in the basal lamina.
Treatment: instruct the patient to use gluten free diet.

Crohn disease:

inflammatory disease mainly affect the terminal ilium of colon and appears to heterogenous disorder caused by commensal bacteria (mycobacterium paratuberculosis) that causes disregulation of mucosal T-lymphocyte.
Dental aspect:
1-oral ulceration. 2-facial and labial swallowing.
3-angular stomatitis.
4-high prevalence of careis and periodontitis.
Dental management:
1- Corticosteroids. 2-avoid NSAIDs 3-Avoid antibiotic that aggravate diarrhea such as amoxillin and clindamycine.
Ulcerative colitis: occur in colon.
Causes: 1-chroni blood loss. 2-reccurent aphtus ulceration. 3-stomatitis. 4-TMJ may be affected. 5- arthritis due to steroid therapy.
Compliction:1-colonic cancer. 2- recurrent aphtus ulceration.
Treatment: Voncomycine 25mg, 6 hour, 7 days.