Functional bowel disorders Flashcards

1
Q

What is detectable in an organic bowel disorder?

A

Organic pathology

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2
Q

Give 2 examples of organic pathology

A

macroscopic - cancer

microscopic - colitis

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3
Q

What does the prognosis of organic disorders depend on?

A

the pathology

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4
Q

What are functional bowel disorders related to?

A

gut function with no underlying pathology

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5
Q

What is the long term prognosis of functional bowel disorders?

A

good

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6
Q

What are some examples of functional bowel disorders?

A

oesophageal spasm

IBS, biliary dyskinesia, drug related effects, slow transit constipation, non ulcer dyspepsia

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7
Q

What are very important to consider with functional bowel disorders?

A

psychological factors

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8
Q

What is non ulcer dyspepsia?

A

dyspeptic type pain but no ulcer on endoscopy

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9
Q

What are some possible causes or NUD?

A

microscopic ulceration, reflux, IBS, delayed gastric emptying

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10
Q

If a patient is under 45 what are the 2 important things to check?

A

H pylori + ALARM

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11
Q

If H pylori is negative what do you treat?

A

The symptoms eg PPI

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12
Q

If you are in doubt about the diagnosis what should you do?

A

endoscopy

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13
Q

What is nausea?

A

The feeling of being sick without actually vomiting

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14
Q

What is retching?

A

Dry heaves

antrum contracts on a closed glottis

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15
Q

What is vomiting?

A

Contents expelled

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16
Q

What is the chemoreceptor trigger zone and give examples of stimulators

A

vomiting centre

chemotherapy, opiates, digoxin, uraemia

17
Q

Give the 3 time periods of eating and being sick and try and think of what the cause may be?

A

immediate - psychogenic
1 hour + - pyloric obstruction, motility disorder, diabetes
12 hour - obstruction eg hernia/stricture

18
Q

What are some functional causes of vomiting?

A

pregnancy, alcohol, drugs, abdominal migraine, cyclical vomiting syndrome

19
Q

What is cyclical vomiting syndrome?

A

childhood onset

2-3 times a month to 2-3 times a year

20
Q

What is psychogenic cause of vomiting linked with?

A

bulimia usually young women

21
Q

What is the normal bowel habit and what specific changes are of note?

A

normal for you!

change in frequency, consistency, blood, mucus

22
Q

How are some ways to examine a patient with altered bowel habits?

A

rectal examination
ask with relation to Bristol stool chart
family history
physical examination

23
Q

There are 10 ALARM symptoms - name as many as you can

A

over 50, male, rectal bleeding, unintentional weight loss, recent onset, mass, anaemia, family history, recent antibiotic use, nocturnal symptoms

24
Q

What are some investigations you would do in altered bowel habits patient?

A

FBC, U+E’s, thyroid, blood glucose, coeliac serology

sigmoidoscopy, proctoscopy and colonoscopy in IBD

25
What are some systemic causes of constipation?
diabetes, hypothyroidism, hypercalcaemia
26
What are some functional causes of constipation?
depression, idiopathic, megacolon
27
What are some organic causes of constipation?
tumours, strictures, anal fissure, diverticular disease
28
What are some neurogenic causes of constipation?
parkinsons, spinal injury, stroke
29
List some symptoms of IBS
bloating, wind/flatus, abdominal pain radiating to the lower back, altered bowel habit, rectal bleeding, improvement after defaecation, urgency
30
What are the 3 types of IBS
IBS-C constipation IBS-D diarrhoea IBS-M both
31
What are people with IBS more aware of?
Their digestive system
32
What is the difference between IBS-c and IBS-d?
D - more harder contractions, hears the brain messages too loudly and is over responsive
33
What is calprotectin and what is it used for in relation to IBS?
Released by inflamed gut mucosa | differentiate IBS+IBD and to monitor IBD
34
What are some non drug treatments of IBS?
dietetic review eg FODMAP and reintroduction | hypnotherapy and relaxation
35
What medications are used for the pain, bloating, IBS-C and IBS-D?
pain - antispasmodics and antidepressants bloating - probiotics C - laxatives, fibres, osmotics D - antimotility drugs and FODMAP