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Alimentary System > Bowel Disorders > Flashcards

Bowel Disorders Flashcards

1
Q

what are the 2 broad categories of GI disease?

A

> structural

> functional

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2
Q

what are the effects of functional GI disorders?

A

> impact quality of life
cause absence from work
no association with development of serious pathology

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3
Q

what could cause non-ulcer dyspepsia?

A

> reflux
low grade duodenal ulceration
delayed gastric emptying
irritable bowel syndrome

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4
Q

how would you diagnose non-ulcer dyspepsia?

A

> history and examination
h. pylori status
alarm symptoms

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5
Q

is all investigations are negative in the diagnosis of non-ulcer dyspepsia how do you proceed?

A

> treat symptomatically

> do endoscopy if in doubt

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6
Q

describe retching

A

dry heaves where the antrum contracts but the glottis is closed

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7
Q

what would immediate vomiting after eating suggest?

A

it is psychogenic

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8
Q

in obstruction how long would you expect there to be between eating and vomiting?

A

12 hours

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9
Q

what conditions may cause vomiting an hour or more after eating?

A

> pyloric obstruction

> motility disorders: diabetes, post gastrectomy

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10
Q

name some functional causes of vomiting

A 
> drugs
> pregnancy
> migraine
> cyclical vomiting 
> alcohol
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11
Q

name some functional diseases of the lower GI tract

A

> irritable bowel syndrome

> slow transit constipation

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12
Q

what would you consider when asking about changes in bowel habit?

A 
> what is their normal
> changes in frequency
> changes in consistency
> blood present
> mucus
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13
Q

name some alarm symptoms

A 
> >50years
> short history
> weight loss
> nocturnal symptoms
> male
> family history of cancer
> anaemia
> rectal bleeding
> antibiotic use
> abdominal mass
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14
Q

what is the aetiology of constipation? (four broad categories)

A

> systemic
neurogenic
organic
functional

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15
Q

what investigations could you carry out when assessing the patient after history is taken?

A 
> FBC
> U and Es
> blood glucose
> thyroid status
> coeliac serology
> proctoscopy
> sigmoidoscopy
> colonoscopy
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16
Q

what organic things can cause constipation?

A 
> strictures
> tumours
> diverticular disease
> proctitis
> anal fissure
17
Q

what functional reasons can there be for constipation?

A 
> megacolon
> idiopathic
> depression
> psychosis
> institutionalisation
18
Q

what are the systemic causes of constipation?

A

> diabetes mellitus
hypothyroidism
hypercalcaemia

19
Q

what are the neurogenic causes of constipation?

A 
> autonomic neuropathies
> parkinson's disease
> strokes
> multiple sclerosis
> spina bifida
20
Q

what are the clinical features of irritable bowel syndrome?

A 
occur relapsing and remitting manner:
> abdominal pain
> altered bowel habit
> abdominal bloating
> wind
21
Q

what are the features of abdominal pain in IBS?

A

> variable character
occasionally radiates to lower back
often altered by bowel action
rarely occur at night

22
Q

describe altered bowel habit in IBS

A 
> constipation (IBS-C)
> diarrhoea (IBS-D)
> diarrhoea and constipation (IBS-M)
> variable
> urgency
23
Q

what causes bloating in IBS?

A

relaxation of the abdominal wall muscles

24
Q

how would you diagnose IBS?

A

> compatible history

> normal physical examination

25
Q

what investigations could you carry out for IBS?

A

> blood analysis
stool culture
calprotectin

26
Q

what releases calprotectin?

A

inflamed gut mucosa

27
Q

what is calprotectin used for clinically?

A

differentiating IBS from IBD and monitoring IBD

28
Q

what is the treatment for IBS?

A 
> education and reassurance
> diabetic review
> drug therapy
> relaxation training
> hypnotherapy
> cognitive behaviour therapy
> psychodynamic interpersonal therapy
29
Q

what can cause IBS?

A

> altered motility
visceral hypersensitivity
stress/anxiety/depression

30
Q

how do contractions of the bowel differ in IBS-D?

A

they are stronger and more frequent

31
Q

describe bowel contractions in IBS-C

A

they are reduced

32
Q

how may contractions of the bowel be triggered?

A

by waking or eating

33
Q

what type of IBS has a greater response to trigger of gut contractions?

A

IBS-D

34
Q

how does awareness of normal digestive processes differ in people with IBS?

A

they often have excessive awareness

Alimentary System (33 decks)

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