Acute GI medicine (Yr 3) Flashcards
what are the severe potentially life threatening forms of diarrhoea?
enteric infection
haemorrhagic gastroenteritis
intestinal obstruction
what are some possible surgical GI diseases?
intussusception
volvulus
incarceration
stricture/partial obstruction
foreign body
where is the majority of water absorbed?
jejunum and ileum
what is the main clinical sign associated with acute enteropathies?
vomiting and diarrhoea
what is inflammation of the small intestines called?
enteritis
what is inflammation of the large intestine called?
colitis
what are the features of small intestinal diarrhoea?
large volume
normal/mild increase in frequency
no tenesmus
no blood/mucous
some weight loss present
what are the features of large intestinal diarrhoea?
normal/increased volume
more frequent defaecation
tenesmus present
some blood/mucous
not usually weight loss
what are some possible causes of acute gastritis?
dietary indiscretions (garbage…)
foreign material
hairballs (bezoars) in cats
some drugs
acute systemic disease
what are the features of diarrhoea associated with acute enteritis?
profuse diarrhoea
normal/increased frequency
no tenesmus
possible melaena (digested blood)
large volumes
what is melaena?
digested blood in the faeces (dark coffee grounds)
what are the features of diarrhoea associated with acute colitis?
frequent small volume diarrhoea
tenesmus
mucoid and possible fresh blood (haematochezia)
what is haematochezia?
fresh blood in faeces
what are some possible causes of acute colitis?
idiopathic
garbage ingestion
whipworms
protozoa (giardia, cryptosporidia…)
what are some symptomatic treatments for diarrhoea?
hydration
restrict feed intake
anti-emetics
gastric mucosal protectants
how should feed intake be restricted in diarrhoea cases?
fasting for minimum of 12 hours
followed by frequent feeding of small amounts of bland low-fat food
what are the two types of anti-emetics?
centrally acting
anticholinergics
what are some centrally acting anti-emetics?
maropitant
metoclopramide
what are some anticholinergic anti-emetics?
atropine
methylscopolamine
what is the major contraindication for using an anti-emetic?
if obstruction hasn’t been ruled out
when should gastric mucosal protectants be used?
persistant vomiting
evidence/risk of ulceration
what drugs are contraindicated in acute enteropathies?
NSAIDs
why are NSAIDs contraindicated in gastric enteropathies?
damage GI mucosa
damage to kidneys if hypovolaemic
what are the pros of antibiotic use in gastric enteropathies?
natural flora is already upset
prevent sepsis if mucosal barrier is compromised
what are the cons of antibiotic use in gastric enteropathies?
upset natural flora
cause diarrhoea
promotes resistance
what are indications for antibiotic use in gastric enteropathies?
haemorrhagic diarrhoea
diarrhoea with pyrexia
known infection (salmonella, E. coli, campylobacter)
what breeds are predisposed to acute haemorrhagic diarrhoea syndrome?
toy and miniature breeds
what are the clinical signs of acute haemorrhagic diarrhoea syndrome?
sudden onset vomiting (blood)
severe bloody diarrhoea
depression
shock
haemoconcentration (high PCV due to massive loss of fluid)
how is acute haemorrhagic diarrhoea syndrome treated?
prompt vigorous fluid therapy (80ml/kg/hr until CRT is normal)
withhold food/water
broad-spectrum antibiotics
protectants
what is the prognosis for acute haemorrhagic diarrhoea syndrome?
untreated - death (shock)
treated - low mortality
