CELIAC DISEASE & DIVERTICULAR DISEASE Flashcards
What is celiac disease?
-a unique autoimmune disease
-also known as gluten sensitive enteropathy
-damage to the small intestinal mucosa from ingestion of wheat, barley, rye and oats
a unique autoimmune disease
celiac disease
also known as gluten sensitive enteropathy
celiac disease
damaged to the small intestinal mucosa from ingestion of wheat, barley, rye, and oats
celiac disease
etiology of celiac disease
-genetic predisposition
-human leukocyte antigen (HLA) DQ2 & human leukocyte antigen (HLA) DQ8 positivity
-gluten ingestion
-immune-mediated response
cause chronic inflammation
gluten ingestion
gluten can be found in
wheat, barley, rye and oats
it also contains peptide called prolamines
gluten
water insoluble and difficult to digest
gluten
explain the characteristics of gluten
-found in wheat, rye, barley and oats
- contain peptide called prolamines
- water insoluble and difficult to digest
Clinical manifestations of celiac disease
-foul-smelling diarrhea
-steatorrhea
-flatulence
-abdominal distention
- osteoporosis
complications of celiac disease
Autoimmune disease
1. rheumatoid arthritis
2. type 1 diabetes mellitus
3. thyroid disease
What is the confirmatory criteria (diagnosis) of celiac disease?
- there is histological evidence of the disease following biopsy from the small intestine.
- the symptoms and histological evidence disappear when a person eats a gluten-free diet
Management of celiac disease
-Corticosteroid therapy
- gluten-free diet
What medication contains a gluten?
Olmesartan (Benicar)
this can be combined by gluten-free diet if gluten-free diet isn’t effective alone
corticosteroid therapy
what are the gluten-free diet?
wheat, barley, rye and oats
a condition of having a small pockets or pouches in the inside wall of the intestine
diverticular disease
what is diverticular disease?
a condition of having a small pouches or pockets in the inside wall of the intestine.
what is diverticulum?
an outpouching of the mucosa through the circular smooth muscle of the intestinal wall
an outpouching of the mucosa through the circular smooth muscle of the intestinal wall
diverticulum
what are the 2 forms of diverticular disease
- diverticulosis
- diverticulitis
multiple non-inflamed
diverticulosis
a complication of diverticulosis
diverticulitis
diverticula are present
diverticulosis
patient is free of symptoms
diverticulosis
may have alternating periods of constipation and diarrhea
diverticulosis
describe the characteristics of diverticulosis
-multiple noninflamed
-diverticula are present
-patient is free of symptoms
- may have alternating periods of constipation and diarrhea
describe the characteristics of diverticulitis
- inflammation of the diverticula
- occurs when the pocket becomes inflamed or swollen
diverticulosis occurs at what age?
50 years of age
Clinical manifestations of diverticulosis
-usually asymptomatic
- crampy abdominal pain
-relived by passage of flatus
-alternating diarrhea & constipation
Clinical manifestations of diverticulitis
-perforation of the peritonitis
-abscess and fistula formation
-bowel obstruction
-bleeding
stops spontaneously
bleeding
describe the presence of steatorrhea?
excessive fats in the feces
the diagnosis of diverticular disease
- CT scan with oral contrast
- Fecal occult blood test
- Barium enema
- Colonoscopy
test of choice for diverticulosis
ct scan with oral contrast
what is fecal occult blood test
look for blood in the stool
determine narrowing of obstruction in the colonic lumen
barium enema
what is barium enema?
determine narrowing of obstruction in the colonic lumen
the purpose of colonoscopy
to rule out possible hidden of polyps or lesions
to rule out possible hidden of polyps or lesions
colonoscopy
barium enema & colonoscopy are contraindicated in patient who have
contraindicated in patient who have acute diverticulitis
why barium enema & colonoscopy is contraindicated in patients with acute diverticulitis
because of the possibility of perforation and peritonitis
Surgical Management of Diverticular Disease
- resection with temporary diverting colostomy
- reanastomosis after the colon has healed.
what is the management for diverticular disease?
-high fiber diet (during nonasymptomatic periods)
- dietary fiber supplements (during nonasymptomatic periods)
- stool softeners
- clear liquid diet
- oral antibiotics
what’s the management if overweight?
weight reduction
What’s the purpose of NPO status?
to allow the colon to rest and the inflammation to subside
What needs to be watch out for in acute diverticulitis?
WOF symptoms of peritonitis
Possible colon resection
- perforation
- obstruction
- hemorrhage
patient with acute diverticulitis must have
bed rest
