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Chapter 1 - GI System > Chronic bowel disorders > Flashcards

Chronic bowel disorders Flashcards

1
Q

What is Coeliac disease?

A

Autoimmune condition - chronic inflammation of small intestine.

Gluten in wheat, barley, rye - activate abnormal immune response leads to malabsorption of nutrients

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2
Q

How is Coeliac disease treated?

A

strict, life long gluten free diet.

Supplements may be required. Pts should be advised NOT to self medicate with OTC vits

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3
Q

What are coeliac pts at increased risk of due to malabsorption?

A

Osteoporosis and active treatment of any bone disease

Need calcium and vit D

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4
Q

Treatment used for confirmed cases of refractory coeliac disease?

A

Prednisolone can be used whilst waiting for specialist advice.

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5
Q

What is diverticular disease?

A

condition where diverticula (in colon wall) cause intermittent lower abdo pain in the absence of inflammation or infection.

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6
Q

What is diverticuitis?

A

Inflammation and infection of the diverticula - causing lower abdo pain.

usually accompanied by fever, general malaise and sometimes large rectal bleeding

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7
Q

Sulfasalazine belongs to which group of medicines?

A

Aminosalicylates

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8
Q

Sulfasalazine is made up of 5 aminosalicylic acid and sulfapyridine - what’s the function of sulfapyridine ?

A

acts as a carrier to the colonic site of action bit still causes side effects

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9
Q

What other newer aminosalicylates are available? (3)

The sulfonamide related side effects are avoided but 5-ASA still cause side effects including …(2)

A
  1. mesalazine (5-aminosalicylic acid (5-ASA))
  2. Balsalazide sodium (pro-drug of 5-ASA)
  3. Olsalazine sodium
  4. Blood disorders
  5. Lupus like syndrome
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10
Q

What 3 groups of drugs are used in chronic bowel disorders?

examples of each

A
  1. Aminosalicylates
  2. Cytokine modulators e.g Infliximab, Adalimumab, Golimumab
  3. Dugs affecting immune response e.g. folic acid given to reduce methotrexate toxicity
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11
Q

How do Cytokine modulators e.g Infliximab, Adalimumab, Golimumab work?

A

They are monoclonal antibodies which inhibit the proinflammatory
cytokine, tumour necrosis factor alpha. They
should be used under specialist supervision.

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12
Q

What is Crohn’s disease?

What is fistulating crohn’s disease?

A

chronic inflammatory disease mainly affects gastro intestinal tract.

Characterised by:
thickened areas of gastro wall, ulceration etc

Fistulating Crohn’s disease is a complication that involves
the formation of a fistula between the intestine and adjacent
structures, such as perianal skin, bladder, and vagina.

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13
Q

Symptoms of Crohn’s disease? (5)

A
  1. abdo pain
  2. rectal bleeding
  3. diarrhoea
  4. fever
  5. weight loss
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14
Q

Drug and non drug treatment for crohn’s disease?

Add on treatment?

A

non -drug:
smoking cessation
attention to nutrition

drug:
1. corticosteroid (prednisolone or methylprednisolone or intravenous hydrocortisone) - used for first presentation or flare up in a 12 month period

  1. budesonide if above contraindicated in certain pts

Add on treatment for more than two exacerbations in 12 month period:

1. Azathioprine (immunosuppressant) 
or Mercaptopurine (cytotoxic /antimetabolite /chemo)
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15
Q

What treatments can be used for diarrhoea associated with crohn’s disease?

A

in those without colitis:

  1. Loperamide
  2. Codeine
  3. Colestyramine brand name: Questran ( bile acid sequestrants)
    licensed for diarrhoea associated with crohn’s disease
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16
Q

What is Ulcerative colitis?

When does it usually present itself?

Symptoms? (3)

A

chronic inflammatory condition
characterised by diffuse mucosal inflammation - it has relapsing-remitting pattern

between 15-25 years old

Symptoms:

  1. urgent need for defaecation
  2. bloody diarrhoea
  3. abdo pain
17
Q

What are some complications associated with ulcerative colitis? (4)

A
  1. Increased risk of colorectal cancer
  2. Secondary osteoporosis
  3. Venous thromboembolism
  4. Toxic megacolon
18
Q

What’s first line treatment for acute mild to moderate UC?

A

Aminosalicylate with or without corticosteroid

19
Q

What common side effects with aminosalicyates? (11)

A
  1. Arthralgia (pain in joint)
  2. Cough
  3. Diarroheoa
  4. Dizziness
  5. Fever
  6. GI discomfort
  7. Headache
  8. Leucopenia
  9. Nausea
  10. Skin reactions
  11. Vomiting
20
Q

What patient advice should be given with aminosalicyates?

& what should be done if pts show signs?

A 
To report any unexplained:
bleeding
bruising
purapura (purple spots/bruises on skin)
sore throat
fever
malaise

Drug should be stopped immediately and a blood count done if any suspicion of blood dyscrasia

Chapter 1 - GI System (11 decks)

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