Gastroenterology Exam Review: Digestive Tract Diseases, IBD, Hepatitis & GI Cancers for Physician Assistants

Boost your exam performance with this concise podcast-style summary of essential gastroenterology topics from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. Covering the full digestive tract—esophagus, stomach, intestines, liver, biliary tract, and pancreas—this review highlights core diseases, diagnostics, and treatments vital for both the PANCE and clinical practice.

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Esophageal Disorders

• Gastroesophageal Reflux Disease (GERD): Heartburn, regurgitation, and dysphagia; managed with lifestyle changes and acid suppression (antacids, H2 blockers, PPIs).
• Infectious Esophagitis: Seen in immunocompromised patients; common pathogens include Candida, CMV, and HSV. Treated with targeted antifungal or antiviral therapy.
• Esophageal Neoplasms: Primarily squamous cell carcinoma and adenocarcinoma, diagnosed with endoscopy and treated with multimodal approaches.

Stomach & Duodenal Disorders

• Peptic Ulcer Disease (PUD): Most commonly caused by H. pylori infection or NSAID use; symptoms include epigastric pain. Treated with antibiotics for H. pylori and acid suppression.
• Gastritis & Duodenitis: Inflammation due to H. pylori or medications; requires eradication therapy and lifestyle modification.
• Gastric Neoplasms: Includes Zollinger-Ellison syndrome and gastric adenocarcinoma. Management depends on the specific diagnosis and may require surgery or chemotherapy.

Intestinal Disorders

• Inflammatory Bowel Disease (IBD): Crohn's Disease and Ulcerative Colitis—distinguished by site and depth of GI involvement. Treated with corticosteroids, immunomodulators, and biologics.
• Irritable Bowel Syndrome (IBS): Functional disorder with abdominal pain and altered bowel habits; managed through diet, medications, and stress reduction.
• Malabsorption Syndromes: Includes celiac disease (gluten sensitivity) and lactose intolerance; treated with dietary modifications.
• Colorectal Cancer: Arises from polyps; early detection via screening is crucial. Managed with surgery and adjuvant therapy.

Liver, Biliary & Pancreatic Disorders

• Hepatitis: Viral (A, B, C), toxic (alcohol), and autoimmune etiologies. Managed with antivirals and lifestyle changes.
• Cirrhosis & Liver Failure: Chronic liver damage leads to portal hypertension, ascites, and hepatic encephalopathy. Treatment focuses on managing complications and liver transplantation when necessary.
• Cholelithiasis & Cholecystitis: Gallstones and gallbladder inflammation, often requiring cholecystectomy.
• Pancreatic Disorders: Acute pancreatitis (often gallstones or alcohol) and chronic pancreatitis require supportive care; pancreatic cancer has poor prognosis and complex management.

Glossary of Key Terms

• Achalasia: Failure of the lower esophageal sphincter to relax.
• GERD: Gastroesophageal reflux disease, with reflux of stomach acid into the esophagus.
• PUD: Peptic Ulcer Disease—ulcers in the stomach or duodenum lining.
• IBD: Inflammatory Bowel Disease, including Crohn's and Ulcerative Colitis.
• Cirrhosis: Irreversible scarring of the liver.
• Cholecystitis: Inflammation of the gallbladder, usually due to gallstones.

Conclusion: Gastroenterology Mastery for Exam Success

Exam success requires mastery of the full spectrum of GI diseases, from reflux to colorectal cancer. Focus on distinguishing symptom patterns, diagnostic steps, and first-line management for both common and high-risk digestive disorders. Don’t forget to review key terminology, especially for clinical vignettes.

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