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% Document Info
\author{MJC3}
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  /Title (gastrointestinal-system.pdf)
  /Creator (Cheatography)
  /Author (MJC3)
  /Subject (Gastrointestinal System Cheat Sheet)
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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Gastrointestinal System Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{MJC3} via \textcolor{DarkBackground}{\uline{cheatography.com/212269/cs/46131/}}}
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\noindent
\begin{multicols}{3}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}MJC3 \\
  \uline{cheatography.com/mjc3} \\
  \end{tabulary}
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\columnbreak
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  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 16th April, 2025.\\
   Updated 16th April, 2025.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
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  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{4}

\begin{tabularx}{3.833cm}{x{1.30419 cm} x{1.42551 cm} p{0.3033 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{3.833cm}}{\bf\textcolor{white}{Potential Causes of Dyspepsia}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Dyspepsia}} & A non specific term, encompasses a number of symptoms attributable to the upper GI tract. &  \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
{\bf{Oesophagitis}} & Gastro oesophageal reflux disease (GORD). Barrett's oesophagus &  \tn 
% Row Count 9 (+ 4)
% Row 2
\SetRowColor{LightBackground}
{\bf{Gastritis}} & Type: A,B,C &  \tn 
% Row Count 10 (+ 1)
% Row 3
\SetRowColor{white}
{\bf{Peptic Ulcers}} & Gastic ulcers. Duodenal ulcers &  \tn 
% Row Count 12 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{Zollinger-Ellison syndrome}} & a rare condition caused by tumors (gastrinomas) that produce excessive gastrin, leading to overproduction of stomach acid and peptic ulcers. &  \tn 
% Row Count 20 (+ 8)
% Row 5
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\mymulticolumn{3}{x{3.833cm}}{{\bf{Gastric Cancer}}} \tn 
% Row Count 21 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
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\par\addvspace{1.3em}

\begin{tabularx}{3.833cm}{x{1.27021 cm} x{2.16279 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{3 categories of Gastritis}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Type A - AUTOIMMUNE}} & (antibodies against parietal cells). Reduced or no acid secretion and intrinsic factor. Aplastic anaemia due to Vit B12  deficiency. \tn 
% Row Count 6 (+ 6)
% Row 1
\SetRowColor{white}
{\bf{Type B - BACTERIAL}} & {\emph{Helicobacter pylori}} infection. Elevated acid secretion \tn 
% Row Count 9 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{Type C - CHEMICAL}} & Chemicals/drugs eg aspirin. Elevated acid secretion \tn 
% Row Count 12 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Diet \& Lifestyle \& Other drugs}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{3.833cm}}{{\bf{Other causes of Dyspepsia}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Caffeine:}} & PDE inhibitor promotes acid secretion \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
{\bf{Alcohol:}} & Dissolves mucous layer \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{Spicy Food:}} & Capsaicin, Activates TRPV1 but may inhibit acid secretion via vagal inactivation. \tn 
% Row Count 10 (+ 5)
% Row 4
\SetRowColor{LightBackground}
{\bf{Concomitant medication (drugs that can relax LOS):}} & PDEV inhibitors eg sildenafil like drugs. Nitrates (relaxes LOS via PDE activation). Theophylline (Relaxes LOS via PDE inhibition). Drugs with antimuscarinic properties (block muscarinic receptors). Ca2+ channel blockers (prevent calcium entry). \tn 
% Row Count 23 (+ 13)
% Row 5
\SetRowColor{white}
{\bf{Obesity and pregnancy}} & increased intra-abdominal pressure causing reflux. \tn 
% Row Count 26 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{The Oesophagus}}  \tn
% Row 0
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\mymulticolumn{2}{x{3.833cm}}{The mucosa of the oesophagus is  non-keratinzed stratified squamous epithelium} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{The type of muscle in the muscularis of the oesophagus varies by region}} & the superior 1/3 is skeletal muscle, the intermediate 1/3 is skeletal and smooth muscle, the inferior 1/3 is smooth muscle. \tn 
% Row Count 9 (+ 7)
% Row 2
\SetRowColor{LightBackground}
{\bf{Adventitia replaces serosa.}} & {\bf{Serosa}} = a slick covering that helps organs move smoothly (like the outer wrap of your intestines). {\bf{Adventitia}} = a rougher outer layer that holds the organ in place, usually found where organs are attached to other tissues (like parts of the esophagus or rectum). Meaning that part of the organ is not freely moving inside a cavity anymore, but rather fixed or connected to surrounding structures. \tn 
% Row Count 30 (+ 21)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Type A Gastritis}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Destruction of parietal cells}} & Reduced or absent acid secretion. Vitamin B12 deficiency. Anaemia \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
{\bf{Other conditions associated with Type A Gastritis}} & {\bf{Autoimmune thyroiditis}} (Hashimoto's disease). {\bf{Type I Diabetes.}} {\bf{Addison's Disease}} (Adrenal glands, reduced cortisol \& aldosterone). {\bf{Vitiligo}} (skin pigmentation disorder) white patches of skin. \tn 
% Row Count 15 (+ 11)
% Row 2
\SetRowColor{LightBackground}
{\bf{Treatment potentially required}} & Hydroxocobalamin injections \tn 
% Row Count 17 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{3.833cm}{p{0.75526 cm} x{2.67774 cm} }
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Type C Gastritis - Chemical, Drug and Diet}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{SAID's}} & Steroidal anti-inflammatory drugs (SAID's) inhibit phospholipase A2 by promoting expression of annexin 1 and suppressing expression of COX-2. \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
{\bf{NSAID's}} & Non-steroidal anti-inflammatory drugs inhibit the cyclo-oxygenase enzymes. {\bf{COX-1 COX-2}} \tn 
% Row Count 8 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{p{0.3433 cm} p{0.3433 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Barrett's Oesphagus}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{3.833cm}}{Long-standing reflux of acid} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{3.833cm}}{{\emph{About 1 in 10 people with GORD develop Barrett's oesophagus.}}} \tn 
% Row Count 3 (+ 2)
% Row 2
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\mymulticolumn{2}{x{3.833cm}}{Normal stratified squamous epithelium is replaced with simple columnar epithelium with goblet (mucus cells)} \tn 
% Row Count 6 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Acid Secretion}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{M3 and CCK2  (CCKB; gastrin) receptors}} & GTP-binding protein coupled receptor (GPCR). Linked to Gq (stimulates Phospholipase C). Increases intracellular Ca2+ via PIP2 conversion to DAG \& IP3. \tn 
% Row Count 8 (+ 8)
% Row 1
\SetRowColor{white}
{\bf{H2 receptors}} & GTP-binding protein coupled receptor (GPCR) Linked to Gs (stimulates adenylate cyclase) Increases intracellular cAMP \tn 
% Row Count 14 (+ 6)
% Row 2
\SetRowColor{LightBackground}
{\bf{Inhibit or Reduce acid secretion:}} & Proglumide, Misoprostol, H2 Blockers, Atropine, Proton Pump Inhibitors. \tn 
% Row Count 18 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.57918 cm} x{1.85382 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Type B Gastritis - {\emph{Helicobacter pylori}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Associated with:}} & 80\% of gastric ulcers. 95-100\%. of duodenal ulcers. 100\% chronic antral gastritis. gastric cancer (younger infected, greater chance) \tn 
% Row Count 7 (+ 7)
% Row 1
\SetRowColor{white}
{\bf{Gram negative spiral bacterium}} & colonises mucus in both stomach and duodenum. \tn 
% Row Count 10 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{Secretes}} & urea from high urease activity (antral pH raised, gastrin \& acid  secretion increases).  PAF (platelet activating factor). \tn 
% Row Count 16 (+ 6)
% Row 3
\SetRowColor{white}
{\bf{Gram negative}} & Doesn't retain Crystal Violet stain! - {\bf{Pink stain!!!}} \tn 
% Row Count 19 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Eradication of H.pylori}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{First Line treatment}} & ONE WEEK TWICE DAILY Amoxycillin 300mg {\bf{and either}}  Clarithromycin 500 mg {\bf{or}} Metronidazole 400 mg {\bf{and either}} omeprazole 20 mg {\bf{or}} lansoprazole 30 mg. \tn 
% Row Count 9 (+ 9)
% Row 1
\SetRowColor{white}
 & Consider lowest acquisition costs and previous exposure to clarithromycin or metronidazole! \tn 
% Row Count 14 (+ 5)
% Row 2
\SetRowColor{LightBackground}
{\bf{If allergic to penicillin ONE WEEK TWICE DAILY}} & Clarithromycin 500 mg  Metronidazole 400 mg {\bf{and either}}  Omeprazole 20 mg {\bf{or}} lansoprazole 30 mg \tn 
% Row Count 20 (+ 6)
% Row 3
\SetRowColor{white}
{\bf{If allergic to penicillin and previous exposure to clarithromycin and metronidazole ONE WEEK TWICE DAILY}} & Tetracycline 1g and metronidazole 400 mg. Bismuth subsalicylate and omeprazole 20 mg \tn 
% Row Count 26 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{0.89258 cm} x{2.54042 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Mucosa aggressors and protectors}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Protective}} & Mucus, Prostaglandins, Bicarbonate, Mucosal blood flow \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Aggressive}} & Acid, Pepsin, NSAID's, {\emph{H. pylori}}, Drugs, Diet \tn 
% Row Count 4 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Treatment for Dyspepsia}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Surgery (1900-1970's)}} & Gastric vagotomy \& antacids \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{3.833cm}}{{\bf{Drugs (1970's onwards)}}} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
{\bf{Barriers/Protection:}} & Alginate and Sucralfate-antacid and barrier \tn 
% Row Count 6 (+ 3)
% Row 3
\SetRowColor{white}
{\bf{Muscarinic cholinergic receptor antagonists (M3)}} & Pirenzepine \tn 
% Row Count 9 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Selective H2 receptor antagonists}} & Cimetidine, ranitidine, famotidine \tn 
% Row Count 11 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{3.833cm}}{{\bf{Drugs (1990's onwards)}}} \tn 
% Row Count 12 (+ 1)
% Row 6
\SetRowColor{LightBackground}
{\bf{Proton Pump Inhibitors}} & Omeprazole, Pantoprazole, Lansoprazole, Rabeprazole and Esomeprazole \tn 
% Row Count 16 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{protecting gastric mucosa when taking NSAID's}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Synthetic PGE2}} & Misoprostol + NSAID. Problem – smooth muscle relaxation – diarrhoea. \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
{\bf{Antacids eg: TUMS, Rennie.}} & Inhibit acid secretion: {\bf{H2 antagonists}} eg: famotidine. {\bf{Proton Pump Inhibitors (PPI's)}} eg omeprazole, lansoprazole, esomeprazole, pantoprazole. \tn 
% Row Count 12 (+ 8)
% Row 2
\SetRowColor{LightBackground}
{\bf{Selective COX-II inhibitors}} & Diclofenac, refocoxib (Vioxx) \tn 
% Row Count 14 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{Emerging novel NSAIDS (not clinically used)}} & NO-flurbiprofen (nitric oxide releasing derivatives). H2S releasing NSAID's (currently awaiting MAA) \tn 
% Row Count 20 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

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