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Gastro > Benign conditions of the large bowel > Flashcards

Benign conditions of the large bowel Flashcards

1
Q

Name 5 common diseases of the large bowel

A 
Carcinoma of the colon and rectum
Colonic polyps 
Crohns colitis and UC 
Diverticular disease 
Functional disorders
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2
Q

Define diverticular disease

A

mucosal herniation through the muscle coat

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3
Q

What part of the colon is affected in diverticular disease

A

Sigmoid

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4
Q

What type of diet causes diverticular disease

A

Low fibre and high fat - western diet

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5
Q

What is the difference between diverticulitis and diverticulosis

A

Diverticulitis - the presence of diverticular disease with inflammation or infection
Diverticulosis is the presence of diverticular disease without any inflammation or infection

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6
Q

What are the findings of diverticular disease

A

Outpouching of the epithelial lined track

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7
Q

What is the difference between true and pseudodiverticula diverticular disease

A

True diverticula contain all layers of the parent structure. False or pseudodiverticula are mucosal projections through the muscular layer.

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8
Q

What type of condition are true diverticular disease

A

Congenital disease

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9
Q

How can we diagnose diverticular disease

A

Using a barium enema or an endoscopy

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10
Q

Describe the onset of diverticulitis

A

Gradual onset becoming increasingly severe.

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11
Q

What are the signs of diverticulitis

A

tenderness in the left ileac fossa
generally feeling unwell
altered bowel habit

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12
Q

How do we treat uncomplicated diverticulitis

A

Nothing - oral antibiotics if anything

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13
Q

What are the complications of diverticulitis

A

Pericolic abscess which can perforate, bleed or fistulate

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14
Q

How do we treat complicated diverticulitis

A

Hartmann’s procedure (removal of part of the bowel)
Primary resection
anastomosis
drainage

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15
Q

Describe colitis

A

Inflammation of the lining of the colon

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16
Q

What 2 types of colitis can we get

A

Acute and chronic

17
Q

What 5 things can cause colitis

A 
Infective colitis
Ulcerative colitis
Crohn's colitis
Iscaemic colitis
Infective colitis - usually campyylobacter
18
Q

What are the 4 signs of colitis

A

Pain
Blood in stool
Diarrhoea
History of feeling unwell

19
Q

What 5 tests can we do for colitis

A 
Stool sample
Blood tests
Plain X ray
Sigmoidoscopy and biopsy
Barium enema
20
Q

What specific blood tests would be requested in colitis

A

WBC
CRP
Hb

21
Q

Why would we not perform a full colonoscopy in an acute situation

A

Due to the high risk of perforation if there is extensive inflammation

22
Q

What 4 things can we use to treat colitis

A

IV steroids - first line
IV fluids
Iron supplement
GI rest

23
Q

Who is most likely to get ischaemic colitis

A

Elderly

Those with previous arteriopathy

24
Q

What 3 types of arteriopathy should we suspect ischaemic colitis with

A

Coronary artery disease
Cerebral artery disease (stroke)
Peripheral vascular disease

25
Q

Define colonic angiodysplasia

A

Angiodysplasia of the colon occurs when blood vessels in the colon enlarge. They may become fragile and result in occasional bleeding in the gastrointestinal (GI) tract.

26
Q

How can we treat colonic angiodysplasia

A

Angioplasty - embolise blood vessels using coil or chemicals

27
Q

What are the 4 symptoms of large bowel obstruction?

A

Abdominal pain
constipation
abdominal distension
vomiting

28
Q

What are 5 causes of bowel obstruction

A 
Colorectal cancer 
Benign stricture 
Sigmoid or caecal voluvulus (twist in the bowel)
Pseudo-obstruction
Faecal impaction
29
Q

How do we treat bowel obstruction

A

Resuscitate
Operate
Stent

30
Q

Define pseudo-obstruction

A

clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterised by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen.

31
Q

Is pseudo-obstruction pathological or functional

A

Functional

32
Q

Who is most likely to present with pseudo-obstruction?

A

Elderly / debilitated patients

33
Q

How do we treat pseudo-obstruction

A

We cant.

We can only check that it is not a medication causing it and that there is no electrolyte imbalance causing it

34
Q

How do we determine if the patient has chronic constipation?

A

Determining what is normal for them

35
Q

What usually treats chronic constipation

A

Diet

Laxatives

36
Q

What is a small cause of chronic constipation?

A

Motility disorder

Gastro (67 decks)

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