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The Alimentary Canal > Functional GI Disorders > Flashcards

Functional GI Disorders Flashcards

1
Q

What are the 2 broad categories of the GI tract?

A

Structural and Functional

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2
Q

Describe structural GI diseases

A

They have detectable pathology
Prognosis also depends on the pathology

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3
Q

Describe the functional GI diseases

A

No detectable pathology
Related to gut function
Long term prognosis is good

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4
Q

What are some functional GI disorders?

A

Oesophageal spasm, non-ulcer dyspepsia, biliary dyskinesia, IBS, Slow transit constipation and drug related effects

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5
Q

Describe Non-ulcer dyspepsia

A

Dyspeptic type pain
No ulcer on endoscopy
Probably not a single disease - reflux, delayed gastric emptying and IBS

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6
Q

How is non-ulcer dyspepsia diagnosed?

A

FH, H. pylori status, alarm symptoms - if negative then treat symptomatically
If H. pylori positive then eradication therapy
If doubt then endoscopy

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7
Q

What could immediate vomiting be caused by?

A

Psychogenic

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8
Q

What can vomiting 1 hour or more after food be caused by?

A

Pyloric obstruction
Motility disorders - diabetes and post gastrectomy

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9
Q

What are some functional causes for vomiting and nausea?

A

Drugs, pregnancy, migraine, cyclical vomiting syndrome, and alcohol

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10
Q

What can show changes in gut function?

A

Change from normal amount
Change in frequency or consistency
Blood
Mucus

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11
Q

What are the alarm symptoms?

A

Age over 50, weight loss, nocturnal symptoms, male sex, FH, anaemia, rectal bleeding, recent antibiotic use and abdominal mass

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12
Q

What investigations are used?

A

FBC, blood glucose, U+E, thyroid, coeliac serology, FIT testing, sigmoidoscopy and colonoscopy

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13
Q

What are some organic causes for constipation?

A

Strictures, tumours, diverticular disease, proctitis and anal fissure

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14
Q

What are some functional causes for constipation?

A

Megacolon, idiopathic, depression, psychosis, institutionalised patients

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15
Q

What are some systemic causes for constipation?

A

Diabetes mellitus
Hypothyroidism
Hypercalcaemia

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16
Q

What are some neurogenic causes for constipation?

A

Autonomic, Parkinson’s disease, strokes, MS, spina bifida

17
Q

What are the clinical features of IBS?

A

Abdominal pain, altered bowel habit, and abdominal bloating
Can get belching wind and flatus
Mucus

18
Q

What is the NICE diagnostic criteria for IBS?

A

Abdominal pain relieved by defaecation or associated with altered stool frequency and form and also - altered passage, bloating, worse when eating, passage of mucus

19
Q

Describe the abdominal pain in IBS

A

Very variable
Bloating, burning, sharp and occasionally radiates to back
Often altered by bowel action and rarely occurs at night

20
Q

Describe the altered bowel habit in IBS

A

Constipation (IBS-C)
Diarrhoea (IBS-D)
Both diarrhoea and constipation (IBS-M)
Variability and urgency

21
Q

What is bloating like in IBS?

A

Often very prominent
Wind and flatulence
Relaxation of abdominal wall muscles
Mucus in stool

22
Q

What is diagnosis like for IBS?

A

A compatible history
Normal physical exam

23
Q

What investigations are done for IBS?

A

FBC, U+E, LFT, CRP, TFT, Coeliac serology, stool culture, calprotectin, FIT testing, rectal exam

24
Q

What is calprotectin released by?

A

Inflamed gut mucosa

25
Q

What is calprotectin used for?

A

Used for differentiating between IBS and IBD
Also for monitoring IBD

26
Q

What is the treatment for IBS?

A

Education and reassurance
Dietetic review
FODMAP

27
Q

What does the FODMAP diet include?

A

Exclude fructose, lactose, fructans, galactans and polyols

28
Q

Describe drug therapy for IBS

A

Targets symptoms
Pain - antispasmodics, linaclotide
Bloating - probiotics, linaclotide
Constipation - laxatives
Diarrhoea - FODMAP, antimotility agents

29
Q

What are some phycological innervations for IBS

A

Relaxation therapy
Hypnotherapy
Cognitive behavioural therapy
Psychodynamic interpersonal therapy

30
Q

What are the causes for IBS?

A

Altered motility
Visceral hypersensitivity
Stress, anxiety and depression

31
Q

Describe IBS-D + IBS-C and intestinal motility

A

Muscular contractions may be stronger and more frequent than normal
In IBS-C contraction may be reduced

32
Q

When can contractions of intestinal motility happen?

A

By waking and eating
Reduced in IBS-C
Increased and stronger in IBS-D

33
Q

Describe IBS and brain hearing messages from gut

A

In IBS brain hears messages from gut like hunger or urge to toilet more loud
They also have excessive awareness of normal digestion process

The Alimentary Canal (33 decks)

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