DDSEP Motility III Flashcards
What are the dietary interventions for dumping syndrome?
Smaller more frequent meals (6+ daily) and saving liquids after meals that accelerate GE.
Lying after meals, decreasing carbs, complex carbs over simple ones.
Guar gum and pectin helps increase viscosity of food.
What are the pharmacologic interventions for dumping syndrome?
Acarbose will decrease hypoglycemia associated with DS.
Tincture of opium. Anticholinergics, diazoxide, octreotide.
What are the two types of functional dyspepsia?
Meal related = Post-prandial distress syndrome defined by post-prandial fullness and early satiety.
Unrelated - epigastric pain syndrome defined by epigastric pain and burning.
Both should have no evidence of organic disease (IE: at upper endoscopy) and the symptoms should not be a/w stool changes or improvement with BM.
What can chronic bile acid reflux cause?
Previous lap chole can have this which can cuase functional dyspepsia
Within functional dyspepsia PPDS and EPS (Epigastric pain syndrome) which meds tend to help more?
PPDS- prokinetics
EPS- Acid suppressive therapy
TCA’s help patients without delayed gastric emptying. Mirtazapine can help both.
What is useful about mirtazapine in functional dyspepsia?
Mirtazapine is an antidepressant with activity on multiple neurotrasmitters but no effect on gastric sensorimotor function.
It will improve overall symptoms, early satiety, nausea, and weight loss in patients with functional dyspepsia.
What is the significance of methanogen colonization?
Overgrowth of this can lead to slow transit and significant symptoms.
How do you treat small intestinal fungal overgrowth?
Diflucan, itraconazole, nystatin.
What is a disease we need to think about with unexplained gas, bloating, and distention?
Carbohydrate intolerance.
Especially deficiency of intestinal diasaccharidases including lactase, sucrase, maltase or even pan-intestinal diasccharidase deficiency
Diagnose by distal duodenal biopsy and enzyme assay, or breath test (like for fructase)
