Common Conditions - GI

Question 1

Describe colorectal carcinoma.

Answer 1

Common cancer. 
Symptoms of change in bowel habit, with looser, more frequent bowel motions. 
Constipation
Rectal bleeding 
Tenesmus 
Symptoms of anaemia - fatigue, SOB 
Can present with intestinal obstruction

Question 2

Name the epidemiology/etiological factors of carcinoma of the stomach/gastric cancer

Answer 2

Rare under the age of 30
Common in men
Implications of tobacco smoking, diet and genetic factors
Associated with H pylori infection that causes chronic gastritis

Question 3

List the symptoms of gastric cancer and what relieves it.

Answer 3

Epigastric pain.
Relieved by food and antacids.
Associated with anorexia, vomiting, weight loss, nausea and dysphagia

Question 4

Who is mainly affected by carcinoma of the oesophagus?

Answer 4

Mainly 60-70 yr olds

Question 5

What are the symptoms of carcinoma of the oesophagus?

Answer 5

Progressive and unrelenting dysphagia
Difficulty swallowing solid foods which may progress to difficulty swallowing liquids
May have reduced appetite and weight loss

Question 6

What is diverticular disease?

Answer 6

Small flask-like pockets or outpouchings (diverticula) in the colon. Also called diverticulosis.
Common and occurs in about half of people over 60 years. Can have no symptoms.

Question 7

What is diverticulitis?

Answer 7

Due to inflammation of the diverticula.
Occurs with stasis of bowel contents in diverticula.
Present with left iliac fossa pain, altered bowel habit. Can have rectal bleeding, but not always present.

Question 8

What is IBS - Irritable Bowel Syndrome?

Answer 8

Functional Bowel Disorder - intermittent problems with bowel function without underlying disease of colon

Question 9

How do we diagnose IBS?

Answer 9

Using the Rome criteria instead of grouping it under medically unexplained symptoms

Question 10

What are the symptoms of IBS?

Answer 10

Bouts of recurrent abdominal pain, occurring at least 3 days per month for 3 months
Pain relieved with defecation.
Associated with changes in frequency of bowel motion and can be associated with a change in the appearance and form of bowel motion. Mucus may be present.

Question 11

Which group is IBS more common in?

Answer 11

Women

Affects 1 in 5 people

Question 12

What other concurrent functional illnesses may occur - in which systems regarding IBS?

Answer 12

Gynaelogical, urological or MSK systems

Question 13

What is coeliac disease (gluten sensitive enteropathy)

Answer 13

Inflammation of the mucosa of the upper small bowel

Question 14

What improves inflammation of the bowel in coeliac disease?

Answer 14

Removal of gluten from diet

Question 15

What are the etiological factors in coeliac disease?

Answer 15

Genetic and environmental factors

Question 16

When does coeliac disease present?

Answer 16

At any age

Question 17

What are the symptoms of mild vs severe coeliac disease.

Answer 17

Mild - non specific symptoms e.g. malaise and fatigue

Severe - diarrhoea, steatorrhoea, abdominal pain, weight loss

Question 18

What are the main causes of acute hepatitis?

Answer 18

Drugs (paracetamol), infection, alcohol, poisons (carbon tetrachloride)

Question 19

What is the typical presentation of acute parenchymal liver damage?

Answer 19

General unwellness, altered taste, nausea, anorexia, vomiting.
Sometimes jaundice and fever.

Question 20

What are the two major forms of inflammatory bowel disease?

Answer 20

Crohn's disease (CD) 
Ulcerative Colitis (UC)

Question 21

What are the main symptoms of inflammatory bowel disease?

Answer 21

Diarrhoea, abdominal pain, weight loss

Question 22

What are the other symptoms associated with inflammatory bowel disease?

Answer 22

Low energy, anorexia, nausea, vomiting, low-grade fever

Question 23

Name the characteristics of Crohn’s disease.

Answer 23

Affects the GI tract, if it involves the colon, blood diarrhoea is present.

Question 24

Name the characteristics of Ulcerative Colitis.

Answer 24

Affects the colon.
Presents with bloody diarrhoea and lower abdominal discomfort. Frequency of diarrhoea can be 20x per day and present at night. Urgency and fecal incontinence.