Functional bowel disorders

Question 1

Functional gut disorders

Answer 1

No structural or tissue abnormality
Many symptoms but no pathology
could be due to distubded motitlity, visceral hypersentitiity, brain-gut dysfincton, pshycosocail factors
-no biochemcial tests

Question 2

How to diagnose a functional gut problem

Answer 2

exclusion criteria - IDA, weight loss, dysphagia - definilty not funcitonal gut disoder

Question 3

IBS - symptoms and assocaited symptoms

Answer 3

-normally occurs in young people
constipation to diarrhoea - abdominal pand typically relieved with defacation
-symptooms - urgency, mucous,bloading, flatulance
-may occur after gastroenteritis
-associated symptoms - fatigue, fuctional dysplasia, early satiety , backache, headache poor sleep

Question 4

Pathophysiology of IBS

Answer 4

altered gut motlity 
Visceral hypersensitivity (increased sensitivity to painful stimuli), also can get around to surrounding tissues (brain processing differnet)

Question 5

Treatment of IBS

Answer 5

• conventional - fiber, laxativesm antimotility drugs
• dietary - food diary with response to what is wrong, intolerance rather than allergy , foodmaps - to do with sacaride fermentation, probiotics
• natural lifetstyle - slower meals, avoid stress

Question 6

Pathophysiology of Inflammatory bowel disease

Answer 6

disruption of epithelial barrier
abnormal immune responses and triggering of inflammation
certain microbes in gut may be pathogenic and initiatie IBD

Question 7

Ulcerative colitis - histology

Answer 7

disease limited to colon
muscosal inflammation 
crypt distrotion and atrphy
neutrophils invade cryps - absess
loss of goblet cells
paneth cell metaplasia - paneth cells seen in areas in which they are not normally found

Question 8

Ulcerative colitis - clinical and lab tests

Answer 8

diarrhoea with blood
frequent bowel motions and urgency
abdominal discomfort
fever, malaise, weight loss
lanb tests - inflammatory markers raised ESR, CRP, neutrophiils, mild anaemia, raised ferritin
-if prolonged bleeding may result in IDA

Question 9

CROHNS disease

Answer 9

transmural inflammation
-starts as ulcer on mucosea, progress to deep penetrating ulcers with fishering, and then get mucosa swallone with a cobblestone appearance