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Yr2 GI Joe > Functional bowel disorders > Flashcards

Functional bowel disorders Flashcards

1
Q

What are the main functional bowel disorders?

A

Oesophageal spasm

Non-Ulcer Dyspepsia (NUD)

Biliary Dyskinesia

Irritable Bowel syndrome

Slow Transit Constipation

Drug Related Effects

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2
Q

Functional disorders have a good long term prognosis because there is no detectable __________

A

pathology

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3
Q

Most functional bowel disorders can be traced back to a ________ cause

A

psychological cause

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4
Q

What is Non-ulcer dyspepsia (NUD)?

A

Repeated Dyspepsia (indigestion) in which there is no definite organic cause

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5
Q

What is thought to cause non-ulcer dyspepsia?

A

Probably some combination of:

Reflux

Low grade duodenal ulceration

Delayed gastric emptying

Irritable bowel syndrome

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6
Q

If someone vomits immediately after eating, the cause is likely…

A

Psychogenic

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7
Q

What are the potential causes for vomitting 1 or more hours after eating?

A

Pyloric obstruction

Motility disorders such as diabetes or post gastrectomy

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8
Q

What would cause vomitting >12 hours after eating?

A

Obstruction

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9
Q

What are the functional causes for vomitting?

A

Drugs

Pregnancy

Migraine

Alcohol

Clinical vomitting syndrome

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10
Q

What is meant by ‘psychogenic vomitting’?

A

Psychogenic nausea and vomiting is defined as vomiting without any obvious organic pathology or vomiting with a psychological etiology

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11
Q

What are the functional bowel disorders of the lower GI tract?

A

Irritable bowel syndrome (IBS)

Slow transit constipation

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12
Q

What is the chart used to identify different types eh pooh

A

Bristol stool chart

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13
Q

What symptoms are ‘alarm bells’ and indicate a more serious illness?

A

Age >50

Short symptom history

Weight loss

Male

Family history

Nocturnal symptoms

Anaemia

Rectal bleeding

Recent antibiotic use

Abdominal mass

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14
Q

What are the possible ‘organic’ causes for constipation?

A

Strictures

Tumours

Diverticular disease

Proctitis

Anal fissure

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15
Q

What are some functional causes for constipation?

A

Megacolon

Idiopathic constipation

Depression

Psychosis

Institutionalised patients

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16
Q

What are the systemic causes of constipation?

A

Diabetes mellitus

Hypothyroidism

Hypercalcaemia

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17
Q

WHat are the neurogenic causes for constipation?

A

Autonomic neuropathy

Parkinson’s

Strokes

Multiple sclerosis

Spina bifida

18
Q

What are the alternative names for Irritable bowel syndrome?

A

Spastic colon

Nervous colon

Unstable colon

Mucous colitis

19
Q

What are the main clinical features of IBS?

A

Abdo pain (variable in character)

Altered bowel habit

Abdo bloating

Belching wind / flatulence

Mucous in stool

20
Q

What sort of pain is associated with IBS?

A

Variable in nature (sharp, dull etc)

Relieved by defecation

Rarely occurs at night

21
Q

What is the difference between IBS-C, IBS-D and IBS-M?

A

IBS-C = IBS with constipation

IBS-D = IBS with diarrhoea

IBS-M = IBS with diarrhoea and constipation

22
Q

What examination findings would indicate IBS?

A

None

23
Q

What is calprotectin?

A

Molecule released by inflamed gut mucosa

24
Q

Why is calprotecting useful in the investigation of IBS?

A

Can be used to differentiate between IBS and IBD

25
Q

What are the investigations for IBS?

A

Blood analysis

Stool culture

Calprotectin

FIT testing

Rectal examination?

Colonoscopy?

26
Q

What is the basic treatment strategy for IBS?

A

Education & reassurance

Dietetic review

Drugs

27
Q

What specific diet is recommended for those with IBS?

A

FODMAS

(Fermentable Oligo-, Di- and Mono-Saccharides and Polyols)

28
Q

What drugs can be used to treat the pain in IBS?

A

Antispasmodics

Linaclotide (for IBS-C)

29
Q

What drugs can be used to treat the bloating in IBS?

A

Some probiotics

Linaclotide (for IBS-C)

30
Q

What drugs can be used to treat constipation for those with IBS?

A

Laxatives

Linaclotide

(if constipation then avoid the FODMAP diet)

31
Q

What agents can be used to treat the diarrhoea in IBS-D?

A

Antimotility agents

FODMAP diet

32
Q

What psychological interventions can be used to treat IBS?

A

Relaxation training

Hypnotherapy

Cognitive behavioural therapy

Psychodynamic interpersonal therapy

33
Q

Relaxation therapy is especially useful for treating IBS patients with…

A

Diarrhoea

Psychological comorbidity

34
Q

Hypnotherapy is especially useful for treating IBS patients with…

A

Pain

Constipation

Flatulence

Anxiety

35
Q

What is cognitive behavioural therapy?

When is it most useful?

A

Identifying symptom triggers and learning how to respond more appropriately

Most useful for:

Abdo pain, bloating and flatulence

36
Q

When is cognitive behavioural therapy not indicated?

A

Contraindications are:

  • Depression
  • Patients who believe in a physical cause for their symptoms
37
Q

What is psychodynamic interpersonal therapy?

When is it useful?

A

Educating the patient on how their emotions and bowel symptoms interrelate

Useful for:

  • A history of abuse
38
Q

What are the contraindications for psychodynamic interpersonal therapy?

A

Constipation

Constant pain

Depression

39
Q

What are possible underlying causes of IBS?

A

Altered motility

Visceral hypersensitivity

Stress, anxiety, depression

40
Q

How would altered motility lead to IBS?

A

Increased motility = IBS-D

Reduced motility = IBS-C

IBS-M = get facked

41
Q
A

Yr2 GI Joe (28 decks)

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