What GI issues need to diagnosed/treated early lest they cause permanent damage?

Question

What GI issues need to be diagnosed/treated early lest they cause permanent damage or become unrecoverable. An example would colon cancer.

The question is about which possible diagnoses need to be crossed off the list before it is reasonable to take an alternative approach.

For example if colon cancer is a possible diagnosis, one would want testing asap to, hopefully, rule it out.

If CC were the only serious possible diagnosis, then after ruling it out priorities qualitatively change. It becomes reasonable switch to a less aggressive approach, such as the other extreme of simply giving the body time to heal itself.

Could waterborne infections, including Giardia and Criptosporidium, microscopic colitis and bile malabsorption result in permanent damage?

Answer 1

Gastrointestinal conditions that can be acutely life-threatening because of organ rupture, bleeding or sepsis if not diagnosed/treated early:

• Stomach ulcer, gallbladder inflammation, appendicitis, intestinal diverticles, traumatic spleen rupture, antibiotic associated Clostridium difficile overgrowth with toxic megacolon
• Esophageal varices or hepatic encephalopathy due to liver cirrhosis
• Intestinal hernia, severe constipation, ingestion of a foreign object --> intestinal obstruction
• Acute mesenteric ischemia, for example, in a patient with heart arrhythmia in whom a blood clot dislodges from the heart and blocks an intestinal artery
• Gastric ischemia due to opioid overdose, pneumonia, acute alcoholic hepatitis, cocaine overdose

Gastrointestinal conditions that can result in permanent damage if not treated early:

• Gastric reflux --> Barrett’s esophagus, laryngopharyngeal reflux --> damage of the vocal cords
• Chemical (caustic) injuries --> scars/stenosis in the throat, esophagus or stomach
• Repeated acute hepatitis (due to alcohol), cholecystitis (due to gallstones) and pancreatitis (due to alcohol, gallstones) --> often irreversible chronic hepatitis, chronic cholecystitis or chronic pancreatitis
• Chronic H pylori infection of the stomach --> gastric cancer
• Celiac disease, Crohn's disease --> malabsorption --> osteoporosis
• Inflammatory bowel disease --> strictures, adhesions, fistulas, primary sclerosing cholangitis
• Colorectal cancer and other GI cancers --> metastases, partial organ removal often required
• Atherosclerosis of intestinal arteries --> chronic mesenteric ischemia --> partial intestinal necrosis
• Tapeworm infestation (cysticercosis or echinococcosis) --> cysts in various parts of the body (brain, muscles, liver)

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GI conditions that less likely result in permanent damage:

• Food poisoning and other acute GI viral and bacterial infections
• Parasitic infections, such as giardiasis and cryptosporidiasis, can become chronic, but the damage is rarely permanent
• Irritable bowel syndrome
• Food intolerances (lactose intolerance, fructose malabsorption) and allergies
• Benign tumors
• Hemorrhoids
• Microscopic (lymphocitic, collagenous) colitis triggered by certain drugs, celiac disease, infections, rheumatoid arthritis, psoriasis