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systems- GI > Functional Bowel Disorders > Flashcards

Functional Bowel Disorders Flashcards

1
Q

what are the 2 broad categories of GI disorders?

A

structural and functional

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2
Q

what is the structural GI disorders?

A 
Detectable pathology
Macroscopic e.g. a Cancer
Microscopic e.g.  Colitis
Usually Both
Prognosis depends on pathology
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3
Q

what is the functional GI disorders?

A

No detectable pathology
Related to gut function
“Software faults”
Long-term prognosis good

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4
Q

what are the functional GI disorders?

A 
Oesophageal spasm
Non-Ulcer Dyspepsia (NUD)
Biliary Dyskinesia
Irritable Bowel syndrome
Slow Transit Constipation
Drug Related Effects
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5
Q

what diseases can non-ulcer dyspepsia lead to?

A

reflux, low grade duodenal ulceration, delayed gastric emptying and irritable bowel syndrome

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6
Q

if any doubt of non ulcer dyspepsia what should you perform?

A

endoscopy

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7
Q

functional causes of non ulcer dyspepsia

A 
Drugs
Pregnancy
Migraine
Cyclical Vomiting Syndrome
Onset often in childhood
Recurrent episodes 2-3 x year – 2-3 x month
Alcohol
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8
Q

whatare the functional diseases of lower GI tract?

A

IBS

slow transit constipation

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9
Q

what is considered normal bowel habits in the west?

A

1 stool per day is often considered normal

3 per day may be viewed as diarrhoea

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10
Q

what is considered normal bowel habits in senegal

A

2 stools per day is normal

1 per day is constipated

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11
Q

normal stool weight in uk

A

100-200g/ day

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12
Q

symptoms of diseases of lower GI tract

A 
over 50
unintentional weight loss
male
noccturnal symptoms
family history of bowel cancer
anaemia
rectal bleeding
recent antibiotic use
abdominal mass
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13
Q

investigations for lower GI disease

A 
FBC
Blood glucose
U + E, etc.
Thyroid status
Coeliac serology
FIT testing
Sigmoidoscopy
colonoscopy
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14
Q

aetiology of constipation

A 
Diabetes mellitus
Hypothyroidism
Hypercalcaemia
Autonomic neuropathies
Parkinson's disease
Strokes
Multiple sclerosis
Spina bifida
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15
Q

clinical features of IBS

A 
Abdominal pain
Altered bowel habit
Abdominal bloating
 Belching wind and flatus
mucus
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16
Q

what are the types of altered bowel habits?

A 
Constipation (IBS-C)
Diarrhoea (IBS-D)
Both diarrhoea and constipation (IBS-M)
Variability
Urgency
17
Q

investigation of IBS

A 
Blood analysis
FBC
U & E, LFTs, Ca
CRP
TFTs
Coeliac serology
Stool Culture
Calprotectin
FIT testing
Rectal Examination 
?Colonoscopy
18
Q

what releases calprotectin?

A

inflamed gut mucosa

19
Q

what is used for differentiating IBS and IBD?

A

calprotectin

20
Q

treatment of IBS

A 
A firm diagnosis
Education and reassurance
Dietetic review
Tea, coffee, alcohol, sweetener
Lactose, gluten exclusion trial
FODMAP
21
Q

drug therapy for IBS for pain

A

antispasmodics
linaclotide
antidepressants

22
Q

drug therapy for IBS- bloating

A

some probiotics
linaclotide
avoid bulking agents

23
Q

drug therapy for IBS- constipation

A

laxiti es
linaclotide
avoid TCAs, FODMAP

24
Q

what is the mode of action for relaxation training?

A

uses progressive muscle relaxation, biofeedback, and meditation for stress relief

25
Q

what are the type of patients that would undergo relaxation training?

A

particularly effective in patients with: diarrhoea

psychological comorbidity

26
Q

whats the mode of actin for hypnotherapy?

A

hypnosis induces a state of deep relaxation

27
Q

what type of patients are likely to undergo hypnotherapy

A

patients with pain
constipation
flatulence
anxiety

28
Q

what is the mode of action for cognitive behavioural therapy

A

involves identifying symptom triggers and learning to respond more appropriately

29
Q

what tye of patients are likely to undergo cognitive behavioural therapy?

A

effective for abdominal pain, bloating, flatulence

not effective for depression or when patients believe in a physical cause for their symptoms

30
Q

what is the mode of action for psychodynamic interpersonal therapy

A

helps the patient to undersstand how emotions and bowel symptoms interrelate

31
Q

what type of patients undergo psychodynamic interpersonal therapy

A

particularly effective in patients with a history of abuse

less effective for patients with constipation
constant pain
depression

32
Q

what causes IBS

A

altered motility
visceral hypersensitivity
stress, anxiety, depression

33
Q

what is the bowel?

A

muscular tube that squeezes content from one end to the other

34
Q

contractions of the bowel can be triggered by…

A

waking and eating

35
Q

true or false: the brain hears the gut too loudly in IBS

A

true

36
Q

does having IBS have a heightened gut awareness or less?

A

heightened

systems- GI (40 decks)

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