Common digestive concerns Flashcards
most common disorder diagnosed by gastroenterologists?
IBS
how many people in Canada with celiac?
1/133
0.008%
common symptoms of GERD?
- heartburn
- regurgitation
- sleep disturbance
- postprandial fullness
- localized or diffuse or retrosternal pain or epigastric pain
- early satiety
- upper abdominal distension
complications of GERD?
- Barrett’s epithelium
- erosive esophagitis
- esophageal stricture
- ulceration and bleeding
- esophageal adenocarcinoma
- upper respiratory complaints (wheezing, chronic coughing or throat clearing)
risk factors for developing GERD?
obesity smoking age esophageal stricture parental or family hx of GI diseases high cholesterol diet lung transplantation cystic fibrosis
how to classify IBS-D?
- loose stools >25% of the time
- hard stools
how to classify IBS-C?
- hard stools >25% of the time
- loose stools
how to classify IBS-M?
- both hard and soft stools >25% of the time
- 1/3 to 1/2 of cases
how to classify un-subtyped IBS?
insufficient abnormality of stool consistency to meet criteria IBS-C or M
diagnostic criteria for IBS
- onset of symptoms at least 6 months before diagnosis
- recurrent abdominal pain or discomfort for >3 days per month during previous 3 months
- at least 2 of the following features:
- improvement with defecation
- association with change in stool frequency
- association with change in stool form
describe SIBO etiology
small bowel bacteria should resemble that of oropharyngeal flora (gram +ve aerobic)
in overgrowth, dominated by E Coli, clostridia, bacteroides (gram -ve)
factors: structural lesions, excessive bacterial load, decreased motility, deficiency in host defences
symptoms of SIBO?
diarrhea, anorexia, nausea, weight loss, anemia, pain, malabsorption (low B12, high folate, decrease Hb, increased MCV
diagnosis of SIBO?
predisposing factors, history
testing is either cumbersome and invasive or indirect or non specific/sensitive
tx of SIBO?
optimal tx not yet determined
usually 7-10 day course of antibiotics
which never has peri-anal disease? UC or CD?
UC
endoscopic findings for crohn’s disease?
deep and snake-like ulcers
endoscopic findings for ulcerative colitis?
diffuse ulceration endoscopic changes can be mild
depth of inflammation in UC?
shallow, mucosal
depth of inflammation in CD?
may be transmural, extending through or affecting the entire thickness of the wall of an organ or cavity deep into tissues
which disease commonly has fistulas between organs? CD or UC?
CD
how does a history of smoking affect risk of developing CD vs UC?
increases risk for CD
decreases risk for UC
complications of CD?
blockage of intestine due to swelling or formation of scar tissue, abscesses, pseudo polyps, sores or ulcers (fistulas);
malnutrition
complications of UC?
bleeding from ulcerations, perforation (rupture) of the bowel;
malnutrition
primary test ordered to screen for celiac disease?
anti-tissue trans glutaminase antibodies, IgA
most sensitive & specific blood test for celiac disease - preferred by American College of Gastroenterology
