314 Approach to GI Disease Flashcards
GI tract serves two main functions—assimilating nutrients and eliminating waste.
t
. The stomach secretes —— for vitamin B 12 absorption.
intrinsic factor
ileum is better suited for absorbing vitamin B12and bile acids.
v
The colonic mucosa dehydrates the stool, decreasing daily volumes of 1000–1500 mL in the ileum to 100–200 mL expelled from the rectum.
v
Antimicrobial peptides secreted by intestinal Paneth cells also defend against luminal pathogens
v
The most common intestinal maldigestion syndrome, , produces gas and diarrhea after ingestion of dairy products and has no adverse outcomes.
lactase deficiency
syndrome damage the intestinal mucosa, impair pancreatic enzyme activation, and accelerate transit due to excess gastric acid.
Zollinger-Ellison
Small-intestinal obstruction most commonly results from ….. but may also occur with Crohn’s disease, radiation- or drug-induced strictures, and less likely malignancy.
adhesions
The most common cause of colonic obstruction is …., although inflammatory strictures develop in patients with inflammatory bowel disease (IBD), after certain infections such as diverticulitis, or with some drugs.
colon cancer
characterized by impaired esophageal body peristalsis and incomplete lower esophageal sphincter relaxation.
Achalasia
causes marked delays in small-bowel transit due to enteric nerve or intestinal smooth-muscle injury.
Intestinal pseudoobstruction
The most common causes of abdominal pain are IBS and functional dyspepsia.
t
Fecal mucus is common in IBS, whereas pus and blood characterize IBD.
n
Celiac disease may present with dermatitis herpetiformis.
Celiac disease may present with dermatitis herpetiformis.
Sudden awakening from sound sleep by pain suggests organic rather than functional disease.
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Loose stools after gastrectomy or c cystectomy suggest dumping syndrome or postcholecystectomy diarrhea.
t
the Rome criteria exhibit sensitivities and s ificities of only 55–75% indicating the need for careful test selection in patients at high risk of organic disease.
55–75%
Iron-deficiency anemia suggests mucosal blood loss, whereas vitamin B12 deficiency results from intestinal, gastric, or pancreatic disease.
T
Elevations in fecal calprotectin or lactoferrin are found in inflammatory conditions like IBD
t
diets in IBS
low-FODMAP (fermentable oligo-di-monosaccharides and polyols)
B back methods administered by physical therapies are accepted for treating refractory fecal incontinence or constipation secondary to dyssynergia.
t
