Diarrhoea and constipation

Question 1

consequences of diarrhoea?

Answer 1

dehydration (Na/h2o loss)
metabolic acidosis (HCO3 loss)
hypokalaemia (K loss)

Question 2

basic solution for rehydration therapy?

Answer 2

6tsp glucose, 0.5 tsp salt in 1l of water

Question 3

lifestyle advice for diarrhoea?

Answer 3

stay hydrated, dilute better than water
reintroduce simple foods gradually
avoid greasy, spicy or acidic foods

Question 4

how do anti-motility agents help diarrhoea?

Answer 4

inhibit enteric neurons
decreased peristalsis
increase in fluid absorption

Question 5

lifestyle advice for constipation?

Answer 5

more water/less alcohol
eat more fibre
increase exercise/ activity
improve toilet routine

Question 6

4 types of laxative?

Answer 6

bulk laxatives
osmotic laxatives
stool softeners
stimulants

Question 7

what is triple therapy for H.pylori infection?

Answer 7

PPI and 2 antibacterials (amoxicillin and clarithromycin OR metronidazole)

Question 8

what is Cl secretion like when CFTR is closed?

Answer 8

little secretion

Question 9

what happens when CFTR is activated?

Answer 9

generation of 2nd messengers cAMP, cGMP and Ca2+

Question 10

what happens when channel is opened?

Answer 10

Cl- secretion causes Na+/H2O secretion = secretory diarrhoea

Question 11

4 causes of diarrhoea?

Answer 11

• excessive secretion
• impaired absorption of NaCl
• non-absorbable/ poorly absorbable solutes
• hypermotility

Question 12

common cause of secretory diarrhoea?

Answer 12

E coli

Question 13

why would there be an impaired absorption of NaCl?

Answer 13

congenital defects
infection
inflammation and destruction of epithelium

Question 14

what is primary lactase deficiency?

Answer 14

lack of LP allele

Question 15

what is secondary lactase deficiency?

Answer 15

damage/ infection of proximal small intestine

Question 16

what is congenital lactase deficiency?

Answer 16

rare autosomal recessive disease - no ability to digest lactose from birth

Question 17

symptoms of lactose intolerance?

Answer 17

bloating
pain
diarrhoea

Question 18

causes of constipation?

Answer 18

diet low in fibre
neurogenic disorders
sedentary lifestyle
opiates
anti-depressants

Question 19

example of bulk laxative?

Answer 19

fybogel (ispaghula husk)
methylcellulose

Question 20

example of osmotic laxative?

Answer 20

lactulose

Question 21

example of a faecal softener?

Answer 21

docusate sodium

Question 22

example of a stimulant laxative?

Answer 22

senna

Question 23

how can antiemetics help constipation?

Answer 23

increase GI motility without purgation
increase gastric emptying