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GI Anatomy > Functional bowel disorders > Flashcards

Functional bowel disorders Flashcards

1
Q

Define functional bowel disorders

A

Those with no detectable pathology, i.e. organ is fine histologically but there’s a problem with how the organ works

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2
Q

List some functional bowel disorders (4)

A

Irritable bowel syndrome
Oesophageal spasm
Non-ulcer dyspepsia
Biliary dyskinesia

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3
Q

What is non-ulcer dyspepsia (functional dyspepsia)/ symptoms

A

Dyspepsia symptoms without any duodenal/gastric ulcers or gastric cancers:
Epigastric pain
Nausea
Vomiting

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4
Q

How would you assess non-ulcer dyspepsia (2)

A

History + examination
-ask about vomiting esp
-ask about ALARM symptoms
Check for H.pylori infection

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5
Q

Vomiting immediately after eating suggests what diagnosis

A

Psychogenic vomiting

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6
Q

Vomiting an hour or more after eating suggests what diagnosis

A

pyloric obstruction or motility disorders

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7
Q

Vomiting 12 hours after eating suggests what diagnosis

A

Intestinal obstruction

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8
Q

Functional causes of vomiting (5)

A 
Drugs
Pregnancy
Migraine
Cyclical vomiting syndome
Alcohol
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9
Q

4 aetiological types of constipation

A

Organic, e.g. strictures, tumours
Functional, e.g. distended colon
Systemic, e.g. diabetes
Neurogenic, e.g. parkinson’s

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10
Q

What is irritable bowel syndrome

A

Chronic condition characterised by abdominal pain associated with bowel dysfunction.
The pain is often relieved by defecation

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11
Q

Triggers of IBS

A

Stress
Anxiety
Depression

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12
Q

Aetiology of IBS (5)

A

Multifactorial

  • VISCERAL HYPERSENSITIVITY,
  • INTESTINAL FLORA ALTERATIONS,
  • FOOD SENSITIVITY,
  • PSYCHOLOGICAL,
  • GENETIC
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13
Q

Diagnosis of functional bowel disorders like IBS is based on what

A

History

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14
Q

Symptoms (2) /signs (2) of IBS

A

Abdo pain/cramp
Abdo bloating
Altered bowel habit - mixture of both diarrhoea and constipation
Mucus in stool

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15
Q

IBS is often relieved by what

A

Defaecation

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16
Q

What is IBS-D

A

Diarrhoea predominant IBS

-muscular contractions may be stronger + more frequent

17
Q

What is IBS-C

A

Constipation predominant IBS

-Muscular contractions reduced

18
Q

What is heightened in IBS

A

Visceral awareness/sensitivity

19
Q

What is the NICE diagnostic criteria for IBS (4)

A

Abdo pain relived by defection
Altered stool frequency/form
Abdo bloating
Altered stool passage

20
Q

Investigations of functional bowel disorders like IBS (9) - investigations are to exclude other causes

A 
FBC, U&Es, CRP, TFT
Stool studies - culture, calprotectin (to exclude IBD)
Faecal immunochemical testing (FIT) 
Coeliac serology - to exclude it
Sigmoidoscopy - to exclude IBD or CRC
Colonoscopy - to exclude IBD or CRC
21
Q

Treatment of IBS (6)

A

Lifestyle + diet change
Laxatives - if constipation predominant (IBS-C)
Anti-diarrhoeal agents - if diarrhoea predominant (IBS-D)
Anti-spasmodics - to relive abdo pain
Tri-cyclic antidepressants

Cognitive behaviour therapy - if resistant to medical treatment

22
Q

Alarm symptoms suggesting need for investigation (5)

A 
Anorexia
Loss of weight (unintentional)
Anaemia
Recent onset 
Melaena/haematemesis & Masses
23
Q

Questions to ask in a history of someone presenting with functional bowel disorder (7)

A 
What used to be normal bowel habit
Bowel habit frequency
Consistency of stool - loose or hard
Blood in stool
Mucus in stool
Abdo pain/bloating
24
Q

Dietary management techniques for functional bowel disorders

A

Use the FODMAPS (fermentable oligo-, di- and mono-saccharides and polyols) diet - collection of poorly absorbed simple and complex sugars

  • reduce high FODMAP foods
  • have low FODMAP alternatives
25
Q

Give some low FODMAP alternatives (4)

A

Nut milk instead of cow milk
Carrots and lettuce instead of peas and onions
Wheat free bread

GI Anatomy (21 decks)

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