Functional Bowel Disorders Flashcards

1
Q

What are some functional Gi disorders?

A
Oesophageal spasm
Non-ulcer dyspepsia
Biliary dyskinesia
Irritable bowel syndrome
Slow transit constipation
Drug related effects
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2
Q

What is non-ulcer dyspepsia and what causes it?

A

Dyspeptic type pain but no ulcers
Probably due to several diseases (reflux, low grade duodenal ulceration, delayed gastric emptying, irritable bowel syndrome)

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3
Q

What is the cause of immediate vomiting after food?

A

Psychogenic

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4
Q

What could cause vomiting 1 or more hours after food?

A
Pyloric obstruction
Motility disorders (diabetes, post-gastrectomy)
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5
Q

What could cause vomiting 12 hours after food?

A

Obstruction

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6
Q

What are the functional causes of vomiting?

A
Drugs
Pregnancy
Migraine 
Cyclical vomiting syndrome 
Alcohol
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7
Q

What are alarm symptoms of disease?

A
>50 years old
Short symptom history
Unintentional weight loss
Nocturnal symptoms
Male
FH of bowel/ovarian cancer
Anaemia
Rectal bleeding
Recent antibiotic use
Abdominal mass
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8
Q

What investigations are done for functional bowel disorders?

A
FBC
Blood glucose
U + E
Thyroid status
Celiac serology
FIT test
Sigmoidoscopy
Colonoscopy
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9
Q

What are the causes in organic constipation?

A
Strictures
Tumours
Diverticular disease
Proctitis
Anal fissure
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10
Q

What are the causes in functional constipation?

A
Megacolon
Idiopathic constipation
Depression
Psychosis
Institutionalised patients
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11
Q

What are the causes in systemic constipation?

A

Diabetes mellitus
Hypothyroidism
Hypercalcaemia

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12
Q

What are the causes in neurogenic constipation?

A
Autonomic neuropathies
Parkinsons
Strokes
MS
Spina bifida
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13
Q

What are the clinical features of IBS?

A

Abdominal pain
Altered bowel habit
Abdominal blosting

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14
Q

What are the investigations for IBS?

A
Blood analysis
FBC
U+E, LFTs, Ca
CRP
TFTs
Coeliac serology
Stool culture
Calprotectin
FIT testing
Rectal examination
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15
Q

What is calprotectin test used for?

A

Differentiating IBS from IBD and for monitoring IBD

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16
Q

What are the treatments for IBS?

A

Firm diagnosis
Education and reassurance
Dietetic review
Drugs for individual symptoms - pain, bloating, constipation, diarrhoea

17
Q

What are psychological interventions used for IBS?

A

Relaxation training
Hypnotherapy
Cognitive behavioural therapy
Psychodynamic interpersonal therapy

18
Q

What causes IBS?

A

Altered motility
Visceral hypersensitivity
Stress/anxiety/depression

19
Q

How is intestinal motility affected in IBS-D?

A

Muscular contractions may be stronger or more frequent that normal

20
Q

How is intestinal motility affected in IBS-C?

A

Contractions may be reduced

21
Q

How is gut response to triggers affected in IBS-D?

A

Response may be stronger than normal

22
Q

How is gut response to triggers affected in IBS-C?

A

Response may be reduced