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Alimentary System > Functional Bowel Disorders > Flashcards

Functional Bowel Disorders Flashcards

1
Q

What is the basic feature of functional bowel disorders?

A

Pain or discomfort referred to the GI tract with altered bowel function

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2
Q

When does bowel function become abnormal?

A

When it is abnormal for the specific patient and is causing symptoms

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3
Q

Why can functional bowel disorders be difficult to detect and diagnose?

A

They have no/very little detectable pathology

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4
Q

Give 4 examples of functional bowel disorders

A 
Oesophageal spasm 
Non-ulcer dyspepsia 
Biliary dyskinesia 
Irritable bowel syndrome 
Slow transit constipation 
Drug related
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5
Q

If vomiting occurs immediately after eating, what is the cause likely to be?

A

Psychogenic

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6
Q

If vomiting occurs 1 hour or more after eating, what is the cause likely to be?

A

Pyloric obstruction or motility disorders

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7
Q

If vomiting occurs 12 or more hours after eating what is the cause likely to be?

A

Obstruction

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8
Q

Give the causes of functional bowel disorders

A 
Drugs 
Pregnancy 
Migraine 
Cyclical vomiting syndrome 
Alcohol
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9
Q

What lab investigations might be done in functional bowel disorders?

A 
FBC 
Blood glucose 
U&Es
LFTs
Ca 
CRP 
Stool culture 
Calprotectin 
Thyroid status 
Coeliac serology
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10
Q

What imaging investigations might be done in functional bowel disorders?

A

Proctoscopy
Sigmoidoscopy
Endoscopy
Colonoscopy

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11
Q

How should non-ulcer dyspepsia be treated if H. pylori and other investigations are negative?

A

Symptomatically

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12
Q

What are the classes of causes constipation?

A

Systemic
Neurogenic
Organic
Functional

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13
Q

Give an example of a systemic cause of constipation

A

Diabetes mellitus
Hypothyroidism
Hypercalcaemia

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14
Q

Give an example of a neurogenic cause of constipation

A 
Autonomic neuropathies 
Parkinson's disease 
Stroke 
MS 
Spina bifida
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15
Q

Give an example of an organic cause of constipation

A 
Strictures 
Tumours 
Diverticular disease 
Proctitis 
Anal fissure
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16
Q

Give an example of a functional cause of constipation

A 
Megacolon 
Idiopathic constipation 
Depression 
Psychosis 
Institutionalisation/Admission (due to decreased mobility)
17
Q

Give an example of how functional bowel disorders can cause psychological factors

A

Huge impact on quality of life
Major cause of work absences
Affects ability to do normal day-to-day tasks
Can cause incontinence

18
Q

What do alarm symptoms suggest?

A

Severe disease and need for further investigation

19
Q

Give examples of alarm symptoms

A 
Anaemia 
Loss of weight 
Anorexia 
Recent onset of progressive symptoms
Melaena/ Haematemesis
Swallowing difficulty 
Vomiting 
Age > 50 
Rectal bleeding 
Abdominal mass
20
Q

What is nausea?

A

The sensation of feeling sick

21
Q

When should treatment for functional bowel disorders be started?

A

After a firm diagnosis has been reached

22
Q

What drug therapy can be given for pain in functional bowel disorders?

A

Antispasmotics
Linaclotide
Antidepressants

23
Q

What drug therapy can be given for bloating in functional bowel disorders?

A

Some probiotics

Linaclotide

24
Q

What drug therapy can be given for constipation in functional bowel disorders?

A

Laxatives
Linaclotide
Softeners
Osmotics

25
Q

What drug therapy can be given for diarrhoea in functional bowel disorders?

A

Anti motility agents

FODMAP diet

26
Q

What psychological intervention can be given in functional bowel disorders?

A

Relaxation training
Hypnotherapy
Cognitive behavioural therapy
Psychodynamic interpersonal therapy

27
Q

For what patients is relaxation training most effective?

A

Patients with diarrhoea or psychological co-morbidity

28
Q

For what patients is hypnotherapy most effective?

A

Refractory patients

29
Q

For what patients is cognitive behavioural therapy not effective?

A

Patients with depression or patients who believe that the cause of their symptoms is physical

30
Q

For what patients if psychodynamic interpersonal therapy most effective?

A

In patients with a history of abuse

Alimentary System (29 decks)

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