Functional Bowel Disorders Flashcards
What are the 2 broad categories of GI disease?
Structural
Functional
What is the difference between structural and functional GI disease?
Structural has detectable pathology whereas functional does not
What are examples of functional GI disorders?
Oesophageal spasm
Non-ulcer dyspepsia (NUD)
Biliary dyskinesia
Irritable bowel syndrome
Slow transit constipation
Drug related effects
What does NUD stand for?
Non-ulcer dyspepsia
What do functional GI disorders have a large impact on?
Quality of life
Psychological factors
What are functional GI disorders not associated with that structural disorders are?
Serious pathology
What is non-ulcer dyspepsia?
Chronic or recurrent abdominal pain or nausea, without an ulcer
What is the helicobacter pylori status of non-ulcer dyspepsia?
It varies
What diseases i non-ulcer dyspepsia probably a combination of?
Reflux
Low grade duodenal ulceration
Delayed gastric emptying
Irritable bowel syndrome
What does the diagnosis of non-ulcer dyspepsia involve?
Careful history and examination - FH is important
H Pylori status
Alarm symptoms
If in doubt, endoscopy
What therapy is required for non-ulcer dyspepsia when H Pylori is positive?
Eradication therapy
What is nausea?
The sensation of feeling sick
What is retching?
Dry heaves (antrum contracts, glottis closed)
What is vomiting?
Abdominal contents expelled
What is often found in the history of nausea and vomiting immediately, 1 hour or more, 12 hours?
Immediate cause is psychogenic
1 hour or more is due to pyloric obstruction or motility disorders (diabetes, post gastrectomy)
12 hours or more is obstruction
What are some functional causes of nausea and vomiting?
Drugs
Pregnancy
Migraine
Cyclical vomiting syndrome
Alcohol
What is psychogenic vomiting?
Vomiting without any obvious organ pathology or with a psychological aetiology
Who often suffers from psychogenic vomiting?
Young woman
What often happens to psychogenic vomiting after admission?
It stops
What is irritable bowel syndrome?
Condition of the digestive system that can cause crampls, bloating, diarrhoea and constipation
What is slow transit constipation?
Reduced motility of the large intestine caused by abnormalities of the enteric nerves
How does bowel habit from person to person vary?
There is a great variation in both bowel habit and stool weight
What is the average stool weight in the UK?
100-200g/day
What should be known about the interpretation of the word constipation?
It means different things to different people, so a better approach is to ask the patient about changes in the frequency, consistency, presence of blood or mucus from there normal
What are alarm symptoms relating to constipation?
Age >50 years
Short symptoms history
Unintentional weight loss
Nocturnal symptoms
Male sex
Family history of bowel/ovarian cancer
Anaemia
Rectal bleeding
Recent antibiotic use
Abdominal mass
What investigations should be done for slow transit constipation?
Colonoscopy
FBC
Blood glucose
U + E
Thyroid status
Coeliac serology
FIT testing
Sigmoidoscopy
What are different categories of the aetiology of constipation?
Systemic
Neurogenic
Organic
Functional