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GI System > Functional Bowel Disorders > Flashcards

Functional Bowel Disorders Flashcards

1
Q

Define functional bowel disorders

A

Persistent and recurring GI symptoms, that occur due to abnormal functioning of the GI tract

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2
Q

What are the two different types of FBD and what is the difference?

A
  • Structural: detectable pathology - macroscopic (i.e. cancer) or microscopic (i.e. colitis)
  • Functional: no detectable pathology
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3
Q

Name six different FBD

A
  • Oesophageal spasm
  • Non-ulcer dyspepsia
  • Biliary dyskinesia
  • Irritable bowel syndrome
  • Slow transit constipation
  • Drug related effects
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4
Q

How can FBD impact psychologically?

A

QOL and cause of work absences

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5
Q

What is the causative organisms of non-ulcerative dyspepsia?

A

H. pylori

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6
Q

How is Non-ulcerative dyspepsia diagnosed?

A
  • History (delayed gastric emptying, IBS) and examination

* H. pylori status and alarm symptoms

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7
Q

What is the treatment of non-ulcerative dyspepsia?

A

Depends on H. pylori status:
• Negative -> treat symptomatically
• Positive -> eradication therapy
• In doubt -> endoscopy

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8
Q

Describe the sympathetic and vagal components of vomiting and nausea

A
  • Vomiting centre - induce vomiting when stimulated
  • Chemoreceptor trigger zone - area of medulla that sense chemical abnormalities in the body (digoxin, chemotherapy, opiates, uraemia) and send excitatory signals to the vomiting centres
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9
Q

Name five functional causes of vomiting

A
  • Drugs
  • Pregnancy
  • Migraine
  • Cyclical vomiting syndrome
  • Alcohol
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10
Q

What can the length of time after eating tell you about the cause of vomiting?

A
  • Immediate -> psychogenic
  • 1 hour or more -> pyloric obstruction or motility disorders (i.e. diabetes, post gastrectomy)
  • After 12 hours -> obstruction
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11
Q

What is psychogenic vomiting?

A
  • Often young women and for Yeats
  • No preceding nausea
  • May be self-induced (overlap with bulimia)
  • Appetite not usually disturbed but may los weight
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12
Q

Name the alarm symptoms for FBD

A
  • Over 50yrs
  • Unintentional weight loss
  • Nocturnal symptoms
  • Male
  • Family history
  • Anaemia
  • Rectal bleeding
  • Recent antibiotic use
  • Abdominal mass
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13
Q

Name the investigations used for FBD

A
  • FBC
  • Blood gucose
  • U+Es
  • Thyroid status
  • Coeliac serology
  • FIT testing
  • Calprotectin stool test
  • Sigmoidoscopy
  • Colonoscopy
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14
Q

What can thyroid status indicate about FBD?

A
  • Hyperthyroidism -> diarrhoea

* Hypothyroidism -> constipation

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15
Q

What does calprotectin stool test indicate?

A

Calprotectin is a protein found on WBC, and is activated when inflammation occurs, so can identify inflammatory bowel conditions

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16
Q

What are four classifications of causes of constipation?

A
  • Organic
  • Functional
  • Systemic
  • Neurogenic
17
Q

Name five organic causes of constipation

A
  • Strictures
  • Tumours
  • Diverticular disease
  • Proctitis
  • Anal fissure
18
Q

Name five functional causes of constipation

A
  • Megacolon
  • Idiopathic constipation
  • Depression
  • Psychosis
  • Institutionalised patients
19
Q

Name three systemic causes of constipation

A
  • Diabetes mellitus
  • Hypothyroidism
  • Hypercalcaemia
20
Q

Name five neurogenic causes of constipation

A
  • Autonomic neuropathies
  • Parkinson’s disease
  • Stroke
  • Multiple sclerosis
  • Spina bifida
21
Q

What is the presentation of irritable bowel syndrome?

A
  • Abdominal pain
  • Altered bowel habit
  • Abdominal bloating
  • Belching wind ans flatus
  • Mucus
22
Q

Describe the features of abdominal pain in IBS

A
  • Variable: vague, bloating, burning, sharp
  • Can radiate to lower park
  • Altered by bowel action
23
Q

What test can differentiate IBS and IBD?

A

Calprotectin stool test - released by inflamed gut mucosa

24
Q

What investigations do you use for IBS?

A
  • Bloods: FBC, U+Es, LFTS, Ca, CRP, TFTs, Coeliac serology
  • Stool culture
  • Calprotectin stool test
  • FIT testing
25
Q

What are the management options of IBS?

A
  • Dietetic review
  • Drug therapy
  • Psychological interventions
26
Q

What is involved in the dietetic review of IBS?

A
  • Lactose, gluten exclusion trial

* FODMAP diet

27
Q

What is involved in the drug therapy of IBS?

A
  • Pain: antispasmodics, linaclotide
  • Bloating: probiotics, linaclotide (IBS-C)
  • Consipation: laxatives, linaclotide
  • Diarrhoea: anti motility agents, FODMAP
28
Q

What are different strategies in psychological interventions for IBS?

A
  • Relaxation training
  • Hypnotherapy
  • Cognitive behavioural therapy
  • Psychogenic interpersonal therapy
29
Q

What are three different causes of IBS?

A
  • Altered motility
  • Visceral hypersensitivity
  • Stress, anxiety, depression
30
Q

What is IBS-C?

A

Constipation

31
Q

What is IBS-D?

A

Diarrhoea

32
Q

What happens to muscular contractions and gut response to triggers in IBS-C and IBS-D?

A
  • IBS-C - reduced

* IBS-D - stronger or more frequent

GI System (28 decks)

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