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Year 2- GIT > Functional GI Disorders > Flashcards

Functional GI Disorders Flashcards

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1
Q

What are the two categories of GI disease?

A

Functional
Structural

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2
Q

Which category of GI disease is there more likely to be detectable pathology?

A

Structural GI disease

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3
Q

List some functional GI diseases.

A

Oesophageal spasm
Non-ulcer dyspepsia
Biliary dyskinesia
IBS
Slow transit constipation

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4
Q

Describe what happens in patients with non-ulcer dyspepsia.

A

Ulcer like pain but in absence of ulcer

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5
Q

Which part of the history is particularly important for the diagnosis of non-ulcer dyspepsia?

A

Family history, in particular gastric cancer or coeliac disease

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6
Q

Which other things are important to check if suspicious of non-ulcer dyspepsia?

A

H.pylori status
Alarm symptoms

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7
Q

If a patient is negative for H.pylori and does not have any family history or alarm symptoms, how would you treat it?

A

Symptomatically to relieve symptoms, usually with proton pump inhibitors

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8
Q

If a patient is positive for H.pylori, how would it be treated?

A

Eradication therapy

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9
Q

If there is any doubt about a patient’s symptoms concerning the diagnosis of non-ulcer dyspepsia, what can be done?

A

Endoscopy

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10
Q

What is nausea?

A

Sensation of feeling sick

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11
Q

What is retching?

A

Dry heaves- stomach contracts but the glottis is closed

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12
Q

What is vomiting?

A

Stomach contents expelled

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13
Q

What is important to ask when taking a history from someone with vomiting and nausea?

A

How long after eating the symptoms occur

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14
Q

What does it mean if sickness or vomiting usually occurs immediately after eating?

A

It’s psychogenic

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15
Q

What does it mean if sickness or vomiting usually occurs an hour or more after eating?

A

Pyloric obstruction
Motility disorders

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16
Q

What does it mean if sickness or vomiting usually occurs 12 hours after eating?

A

Obstruction further down the GIT

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17
Q

List some of the functional causes of nausea/vomiting.

A

Drugs
Pregnancy
Migraines
Cyclical vomiting syndrome
Alcohol

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18
Q

Describe the rare disorder known as cyclical vomiting disorder.

A

Often presents in childhood, patients get recurrent episodes of severe vomiting.
Can happen a few times a month or few times a year, usually requires hospital admission and IV fluids

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19
Q

Name two lower GI diseases.

A

IBS
Slow transit constipation

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20
Q

How do you assess patients on their gut function?

A

Ask them what is normal for them and how it has changed

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21
Q

What questions can we ask about stool?

A

Change in consistency/frequency?
Blood present- either on wiping or mixed with the stool?

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22
Q

Which chart may be useful for describing stool consistency?

A

Bristol stool chart

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23
Q

Describe the three parts of examination for patients who may have GIT disorders.

A

General examination looking for systemic disease
Abdominal examination
Rectal examination

24
Q

List the Alarm symptoms for lower GIT disorders.

A

Age >50
Short symptom history
Nocturnal symptoms
Family history
Male
Anaemia
Rectal bleeding
Abdominal mass

25
Q

List the investigations used for those with suspected lower GIT disorders.

A

FBC
Blood glucose
U+E’s etc
Thyroid status
Coeliac serology
FIT test
Sigmoidoscopy

26
Q

What does FIT testing involve?

A

Checking for traces of human haemoglobin in stool

27
Q

What is constipation?

A

When the bowel does not get properly emptied

28
Q

What are some of the organic causes of constipation?

A

Strictures
Tumours
Diverticular disease
Proctitis
Anal fissures

29
Q

What are some of the functional causes of constipation?

A

Megacolon
Idiopathic constipation
Depression
Psychosis
Institutionalised patients (those who have been in hospital for a long time)

30
Q

What are some of the systemic causes of constipation?

A

Diabetes
Hypothyroidism
Hypercalcemia

31
Q

What are some of the neurogenic causes of constipation?

A

Autonomic neuropathies
Spina bifida
Multiple sclerosis
Parkinson’s
Strokes

32
Q

What are the clinical features of IBS?

A

Abdominal pain
Altered bowel habit
Abdominal bloating

33
Q

What do the ROME classification guidelines say about symptoms required to diagnose IBS?

A

Recurrent abdominal pain/discomfort for >3 days/month in past three months with two of the following-
1. Improvement w defaecation
2. Onset associated with change in stool form
3. Onset associated with change in stool frequency

34
Q

Describe the abdominal pain felt in patients with IBS.

A

Vague
Burning
Bloating
Sharp
Occasionally radiates to lower back

35
Q

Does IBS related abdominal pain occur during the day or night?

A

Day, nocturnal IBS pain is uncommon

36
Q

What relieves IBS related pain usually?

A

Defaecation

37
Q

What is meant by IBS-C?

A

Constipation predominant IBS

38
Q

What is meant by IBS-D?

A

Diarrhoea predominant IBS

39
Q

What is meant by IBS-M?

A

Mixed diarrhoea and constipation IBS

40
Q

Bloating is a very common symptom of IBS. Describe the bloating experienced in those with IBS.

A

Often very prominent
Can cause wind or flatulence

41
Q

What causes the bloating seen in those with IBS?

A

Relaxation of abdominal muscles

42
Q

List some investigations used for IBS

A

Blood analysis
FBC
U&E, LFTs Ca
CRP
Coeliac serology
Stool culture
FIT testing
Calprotectin
Rectal examination
?Colonoscopy

43
Q

What is calprotectin?

A

Inflammatory protein released by inflamed gut mucosa

44
Q

What is calprotectin used for?

A

To differentiate between IBS from IBD
To monitor IBD

45
Q

Are calprotectin levels raised in IBS or IBD?

A

IBD

Normal in IBS

46
Q

What is the treatment for IBS?

A

Education and reassurance
Diet review

47
Q

What is the FODMAP diet which is followed by some IBS patients?

A

Exclusion diet…idk how much you need to know in detail but helps a patient to work out if there are any triggers

48
Q

Give an example of a type of drug which can help relive IBS patients of pain.

A

Antispasmodics
Linoclotide

49
Q

Give an example of a type of drug which can help relive IBS patients of bloating.

A

Some probiotics
Linoclotide

50
Q

Give an example of a type of drug which can help relive IBS patients of constipation.

A

Laxatives

51
Q

Give an example of a type of drug which can help relive IBS patients of diarrhoea.

A

Antimotility agents
FODMAP

52
Q

Name the psychological treatment options for functional GIT disorders.

A

Hypnotherapy
Relaxation therapy
Cognitive behavioural therapy
Psychodynamic interpersonal therapy

53
Q

Describe the muscular contractions of the large intestine of those with IDB-D.

A

Contractions may be larger and more frequent.

54
Q

Describe the muscular contractions of the large intestine of those with IDB-C.

A

Contractions reduced

55
Q

What can trigger contractions of the large intestine?

A

Walking
Eating

56
Q

What can happen if those who have IBS get stressed?

A

Their IBS becomes chronic as gut is more sensitive to stress

57
Q

Which oil can be beneficial to those with IBS?

A

Peppermint oil

Year 2- GIT (37 decks)

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