Acute and Chronic GI inflammatory disease

Question 1

What is the most common symptom of GI inflammation?

Answer 1

Diarrhoea is a common symptom that ranges in severity from acute to self limited annoyance to a severe life threatening illness

Question 2

What is Gastroenteritis?

Answer 2

Inflammation of the GI tract (acute infectious diarrhoea

Question 3

What are the causes of diarrhoea?

Answer 3

Acute infections Diarrhoea:
Emotional stress
Food intolerance
organic substance
Drugs/infectious agents

Question 4

What is the most common cause of gastroenteritis?

Answer 4

Infection

norovirus

Question 5

What sign determines the severity of diarrhoea?

Answer 5

Whether there is blood within the stool.

Question 6

What are some acute diarrhoea causes?

Answer 6

Infections (norovirus)
Drug induced (NSAIDs)
Chemical (alcohol)
IBD

Question 7

What is the first test to do when someone presents with Chronic Diarrhoea?

Answer 7

Stool culture test.

Question 8

What are the two types of IBD?

Answer 8

Ulcerative Colitis

Crohns Disease

Question 9

What is Ulcerative colitis?

Answer 9

Typically begins in the rectum and may extend continuously to involve the entire colon (only effects the large bowel)

Only usually affects the inner layer of the bowel wall.

Question 10

How is IBD caused?

Answer 10

An immune mediated response

Question 11

What is Crohn’s Disease?

Answer 11

Involves the end of the small intestine and beginning of the colon.
May affect any part of the GIT tract in a patchy pattern.

Can affect all layers of the bowel wall

Question 12

What investigations should be carried out for IBD?

Answer 12

History and examination

Bloods:
Full blood count
Urea and electrolytes
Liver function tests
C reactive protein (CRP)

Stool - C. difficile, other pathogens

Abdominal X-ray

Question 13

What is the medical management of IBD?

Answer 13

Steroids - IV/oral

infliximab, aminosalicylates

Question 14

What surgical management can be done for Crohn’s disease?

Answer 14

• Treatment of complications e.g. perianal disease, fistulae
• Segmental resections
• High risk of disease in remaining bowel

Question 15

What surgical management can be done for Ulcerative Colitis?

Answer 15

• For recurrent episodes, or disease not responding to medical management
• Severe colitis: Sub-total colectomy with end ileostomy • Elective surgery: Panproctocolectomy with ileo-anal pouch
• Permanent cure possibl