Functional Bowel Disorders Flashcards
Name examples of functional GI disorders
- oesophageal spasm
- Non ulcer dyspepsia (NUD)
- Biliary Dyskinesia
- IBS
- Slow transit constipations
- Drug related effects
What is a functional bowel disorder?
No detectable pathology, related to gut function. Not associated with the development of serious pathology (good prognosis)
Low mortality, high symptoms impact
What is a structural bowel disease
Detectable pathology, whether macro/microscopic
What is retching?
Dry heaving, contraction of the antrum and closed glottis.
Causes of nausea/retching /vomitting
Dependant on time after food consumed.
Immediate - Psychogenic
+1 hour - pyloric obstruction, motility disorder (post gastectomy/diabetes)
+12 hours - obstruction
What are functional causes of nausea/retching/vomiting ?
Drugs Pregnancy Migraine Alcohol Cyclical Vomitting Syndrome
Name functional bowel diseases of the lower GI Tract
- Irritable Bowel Syndrome
- Slow transit constipation
What are the ALARM symptoms
Anaemia Late onset >50 (sudden) Anorexia Rectal bleeding Mass/Male
Investigation of lower GI functional bowel disorders
FBC, blood glucose, U&E, thyroid, coeliac serology, FIT test, sigmoidoscopy/colonscopy
Causes of Constipation
Systemic - diabetes, hypothyroidism, hypercalcaemia.
Neurogenic- autonomic neuropathies, parkinson’s, stroke, M.S, spina bifida
Organic - strictures, tumours, diverticular disease, procitis, anal fissue
Functional
Functional Causes of Constipation
Megacolon - abnormal dilation of the colon (often accompanied with paralysis of peristaltic movement)
Idiopathic
Depression
Psychosis
Describe the presentation of IBS
Presents with:
Abdominal Pain
History of irregular bowel habit/bloating.
Colicky pain relived by defecation
FIT & Bloods normal.Normal physical exam = IBS
IBS - AKA nervous/unstable/spastic colon
Generalised abdominal pain
Vague. If pain can be replicated by balloon inflation suggest bowel distension.
What is calprotectin?
Calprotecin is a biomarker found faeces when intestinal inflammation occurs in IBD (inflammatory intestinal disease) released from inflamed gut mucosa
Prevents the need for endoscopy by screening out those with IBS.
And monitors those with IBD
10-60 ug considered normal
Treatment of IBD
Dietetic Review - tea, coffeem alcohol, sweetener,.
Lactose/Glucose exclusion trial.
FODMAP - Fementable oligo,di,monosaccaribdes and polyols. These carbs are resistant to digestion, they reach the far-end of the digestive tract where it is processed by bacteria (causing digestive symptoms in sensitive individuals
