Functional Bowel Disorders Flashcards

1
Q

What is unique about functional bowel disorders?

A

They do not have a single/ any pathological cause

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2
Q

What are symptoms of IBS? Is there a mucosal abnormality? When does it normally begin?

A

Swinging/altered bowel habits; abdominal pain (relieved with defecation); bloating, urgency/incomplete invacuation

No there is no mucosal damage

Is chronic, so must have been present for ~6 months

Typically has an early onset (early 20s)

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3
Q

Can there be associated symptoms with IBS?

A

Yes, backache/headache; poor sleep; urinary symptoms

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4
Q

What are the main points about the pathophysiology of IBS?

A

Impaired gut motility- frequency of contractions altered, exaggerated response to meal

Visceral hypersensitivity- More sensitive to distension. After gastroenteritis more sensitive (peripheral), or damage to nearby tissues (central)
The brain starts to focus on processing unpleasant -stimuli more- Hypervigilance

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5
Q

What are some treatments for IBS?

A

Fibre supplements; laxatives; anti motility drugs eg loperamide; low dose antidepressants

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6
Q

What are the two inflammatory bowel disease we discuss?

A

Crohns disease and ulcerative colitis

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7
Q

What is the link between genetics an IBD?

A
  • First degree relatives are more likely to have IBD
  • Many genes involved
  • Majority of IBD patients have no family history of it
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8
Q

What is the pathophysiology of IBD?

A

-Disruption of epithelium as well as dysregulation of immune system leading to inflammation.

Causes can be a mixture of genetic susceptibility, environmental triggers, immune response and microbes

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9
Q

What is the pathology of ulcerative colitis?

A

Colon inflammation, starting at rectum and going proximally. Inflammation is diffuse and granular, and is only macroscopic in severe disease

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10
Q

What is UC histology?

A

Crypt cells distorted (branch) and atrophy.

Paneth cell metaplasia

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11
Q

How does UC present clinically?

A

Bloody diarrhoea; frequent bowel motions; abdominal dicomfort.

Bloods might show high platelets and neutrophils, mild anaemia and low ferritin

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12
Q

What is the pathology of Crohns disease?

A

Autoimmune, commonly affects ileum and proximal colon.

TRANSMURAL inflammation. Mucosa in severe cases will ‘cobblestone’ as entire gut wall is inflammed

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13
Q

How does crohns present histologically?

A

Transmural inflammation; non-caesating granulomas

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14
Q

How does crohns present clinically?

A

Depends on GI tract affected, but-
inflammation; stricturing; fistulas; perianal problems
Inflammatory- blood with diarrhoea, abdominal pain, dyspepsia
Strictures- pain, distension, vommiting
Fistulas- (enterocutaneous, enteroenteric etc)
Perianal- fistulas, abcesses

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15
Q

What is general treatment for IBD?

A

5-ASA (anti- inflammatory)

Steroids

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