Functional Bowel Disorders

Question 1

what is IBS?

Answer 1

chronic impairment of bowel function

Question 2

are females or males more likely to have IBS?

Answer 2

30-40yo females

Question 3

what other disease may cause IBS?

Answer 3

recent gastroenteritis

Question 4

what is the scoring system for IBS?

Answer 4

rome 3 criteria
pain 3 months +
- improves w defaecation 
- change in stool freq
- change in stool appearance

Question 5

what are ix for IBS?

Answer 5

FBC and Hx

Question 6

symptoms of IBS?

Answer 6

diarrhoea, constipation, abdominal pain, bloating

Question 7

signs of IBS?

Answer 7

mucus in PR area, exaggerated gastro-colic reflex, anaemia

Question 8

what are the 2 types of IBS?

Answer 8

IBS-C and IBS-D

Question 9

tx for IBS-C?

Answer 9

adjusted diet, anti-spasmodics, laxatives (bulk and anti-inflammatory), aminosalicyclates, 5-HT4 antagonists

Question 10

tx for IBS-D?

Answer 10

adjusted diet, anti-spasmodics, antidiarrhoeal, 5-HT3 antagonists

Question 11

what is GORD?

Answer 11

inflammation of oesophagus due to acid reflux from stomach

Question 12

aetiology of GORD?

Answer 12

incompetent LOSphincter, poor oesophageal clearance, pregnancy, large meals

Question 13

what medication may cause GORD?

Answer 13

Ca2+ blocker

Question 14

presenting symptoms of GORD?

Answer 14

heartburn, acid reflux, water brash (excessive salivation), dysphagia, coughing, hoarseness

Question 15

what are red flag s/s associated to GORD?

Answer 15

dysphagia, wt loss, anaemia, vomiting, UGI ulcer, surgery (peptic ulcer)

Question 16

ix for GORD?

Answer 16

gastroscopy, Ba swallow, oesophageal manometry & pH studies

Question 17

tx for GORD?

Answer 17

lifestyle: smoking cess, wt loss, avoid large meals, alcohol
pharmacological: antacids, H2 antagonist, PPI

Question 18

what surgical tx is there for GORD?

Answer 18

fundoplication (lower oesophageal sphincter repair)

Question 19

complications of GORD?

Answer 19

oesophageal adenocarcinoma, barrett’s O, haemorrhage, stricture, oesophagitis

Question 20

3 types of dysplasia diseases?

Answer 20

hiatus hernia, achalasia and gastroparesis

Question 21

what is gastroparesis?

Answer 21

delayed gastric emptying

Question 22

s/s of gastroparesis?

Answer 22

fullness, nausea, vomiting, wt loss, upper ab pain

Question 23

aetiology of gastroparesis?

Answer 23

T2 diabetes, cannabis, systemic disease meds e.g. opiates

Question 24

ix for gastroparesis?

Answer 24

gastric emptying studies

Question 25

tx for gastroparesis?

Answer 25

liquid diet, eat little & often, gastric pacemaker

Question 26

tx for general dysplasia diseases?

Answer 26

PPIs, endoscopic mucosal resection, radio frequency, ablation, argon

Question 27

what are 2 main generic causes of chronic constipation?

Answer 27

dietary or motility disorders

Question 28

tx fo constipation

Answer 28

laxatives, manual evacuation, enema