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GI AM > Functional GI disorders > Flashcards

Functional GI disorders Flashcards

1
Q

What are the 2 types of GI disease?

A

Structural

Functional

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2
Q

What is a structural GI disease?

A

Detectable pathology, either macro or microscopic

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3
Q

What is an example of a macro and microscopic structural pathology?

A 
Macro= cancer
Micro= colitis
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4
Q

What is functional GI disease?

A

Structure is normal and there is no detectable pathology, but function is not working

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5
Q

What is non ulcer dyspepsia?

A

Dyspepsic type pain but no ulcer on endoscopy

Not a single disease, covers a range of things

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6
Q

What disorders does the term non ulcer dyspepsia cover?

A

Reflux
Low grade duodenal ulceration
Delayed gastric emptying
IBS

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7
Q

How is non ulcer dyspepsia diagnosed?

A

History and exam

If in doubt, endoscopy

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8
Q

How is non ulcer dyspepsia treated?

A

Symptomatically

Eradication of H pylori if necessary

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9
Q

How is vomiting controlled?

A

Vomiting centre

Chemoreceptor trigger zone

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10
Q

What can activate the chemoreceptor trigger zone of the vomiting centre?

A

Opiates
Digoxin
Chemotherapy
Iraemia

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11
Q

What does immediate vomiting after eating suggest?

A

Psychogenic disorder

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12
Q

What does vomiting 1 or more hours after eating suggest?

A

Pyloric obstruction

Motility disorders

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13
Q

What does vomiting 12 or more hours after eating suggest?

A

Obstruction of small intestine

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14
Q

What are the functional causes of vomiting?

A 
Drugs
Pregnancy
Migraine
Cyclical vomiting syndrome
Alcohol
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15
Q

What is cyclical vomiting syndrome?

A

Recurrent episodes of severe vomiting for 2-3 days from several times a year to several times a month

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16
Q

What are some features of psychogenic vomiting?

A

Mainly young women
May have no preceding nausea or appetite change
May be self induced, may cause weight loss
Often stops soon after admission

17
Q

What signs and symptoms would cause alarm when paired with a change in stool?

A 
Age, anaemia, abode mass, antibiotic use
Family history
Loss of weight
Male
Nocturnal symptoms
Rectal bleeding
Short symptom history
18
Q

What investigations are done in everyone who has had a change in stool?

A 
FBC
Blood glucose
U+E
Thyroid
Coeliac serology
19
Q

What are the 4 causes of constipation?

A

Systemic
Neurogenic
Organic
Functional

20
Q

What are the systemic causes of constipation?

A

Diabetes mellitus
Hypothyroidism
Hypercalcaemia

21
Q

What are the neurogenic causes of constipation?

A 
Autonomic neuropathies
Parkinson's
Stroke
MS
Spina bifida
22
Q

What are the organic causes of constipation?

A 
Strictures
Tumours
Diverticular disease
Proctitis
Anal fissure
23
Q

What are the functional causes of constipation?

A 
Megacolon
Idiopathic constipation
Depression
Psychosis
Institutionalised patients
24
Q

What are the clinical features of IBS?

A

Abdo pain
Altered bowel habit
Abdo bloating

25
Q

What are the features of IBS pain?

A

Occasionally radiates, mainly to lower back
Often improved by bowel action
Rarely at night

26
Q

What are the types of changes in bowel habit we look for in IBS?

A 
Constipation
Diarrhoea
Both
Variability
Urgency
27
Q

How is IBS diagnosed?

A

Compatible history

Normal physical examination

28
Q

What investigations can be done for IBS?

A 
Blood analysis
Stool culture
Calprotectin
Possible rectal exam and FOB
Colonoscopy if there are concerning features?
29
Q

How is IBS treated?

A

Education and reassurance
Dietetic review
Drug therapy
Psychological intervention

30
Q

What drugs can be used for pain in IBS?

A

Antispasmodics
IBS-C- linaclotide and SSRIs
IBS-D- TCA antidepressants

31
Q

What drugs can be used for bloating in IBS?

A

Probiotics

IBS-C- linaclotide

32
Q

What drugs can be used for constipation in IBS?

A

Laxatives

Linaclotides

33
Q

What drugs can used for diarrhoea in IBS?

A

Antimotiloty agents

34
Q

What psychological interventions can be used in IBS?

A

Relaxation therapy
Hypnotherapy
Cognitive behavioural therapy
Psychodynamic therapy

35
Q

What is the cause of IBS?

A

Altered motility
Visceral hypersensitivity
Stress, anxiety, depression

36
Q

What happens in IBSD?

A

Bowel contractions stronger and more frequent

Response to gut triggers stronger

37
Q

What happens in IBSC?

A

Bowel contractions reduced

Response to gut triggers weaker

GI AM (34 decks)

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