Functional GI Disorders

Question 1

describe functional GI disorder

Answer 1

• no detectable pathology

- related to to gut function

Question 2

prognosis of functional GI disorders

Answer 2

long term prognosis

Question 3

types of functional GI disorders

Answer 3

oesophageal spadm

non-ulcer dyspepsie

biliary dyskinesia

IBS

slow transit constipation

drug related effects

Question 4

how are the majority of functional GI disorders diagnosed

Answer 4

history

examination

Question 5

nausea

Answer 5

the sensation of feeling sick

Question 6

retching

Answer 6

dry heaves

Antrum contracts, glottis closed

Question 7

vomiting

Answer 7

contents expelled

Question 8

chemoreceptor trigger zone function

Answer 8

detects changes in the body and communicates them to the vomiting centre to initiate vomiting

Question 9

factors that can tigger vomiting centre

Answer 9

• receptors for opiates
• digoxin
• chemotherapy
• uraemia

Question 10

type of cause if vomiting occurs immediately after eating food

Answer 10

psychogenic

Question 11

type of cause if vomiting occurs 1 hour after eating food

Answer 11

• pyloric obstruction

- motility disorders

Question 12

type of cause if vomiting occurs

12+ hours after eating food

Answer 12

obstruction etc.

Question 13

functional causes of vomiting

Answer 13

drugs

pregnancy

migraine

cyclic vomiting syndrome

alcohol

Question 14

psychogenic vomiting features

Answer 14

• often young women
• often for years
• no preceding nausea
• self induced?
• Appetite usually not disturbed but may lose weight
• often stops shortly after admission

Question 15

functional diseases of lower GI tract

Answer 15

IBS

slow transit constipation

Question 16

physical examination for functional disease

Answer 16

• look for systemic disease
• careful abdominal examination
• rectal examination

Question 17

assessing patient ALARM symptoms?

Answer 17

• Age >50 years
• short symptom history
• unintentional weight loss
• nocturnal symptoms
• male sex
• family history of bowel/ ovarian cancer
• anaemia
• rectal bleeding
• recent antibiotic use
• abdominal mass

Question 18

investigations for functional disease

Answer 18

• FBC
• Blood glucose
• U+E
• Thyroid status
• Coeliac serology
• FIT testing
• sigmoidoscopy
• colonoscopy

Question 19

primary aetiologies of constipation

Answer 19

1. systemic
2. neurogenic
3. organic
4. functional

Question 20

organic aetiology of constipation

Answer 20

• strictures
• tumours
• diverticular disease
• proctitis
• anal fissure

Question 21

functional aetiology of constipation

Answer 21

• megacolon
• idiopathic constipation
• depression
• psychosis
• institutionalised patients

Question 22

systemic aetiology of constipation

Answer 22

• diabetes mellitus
• hypothyroidism
• hypercalcaemia

Question 23

neurogenic aetiology

Answer 23

• autonomic neuropathies
• parkinsons
• strokes
• multiple sclerosis
• spina bifida

Question 24

types of abdominal pain

Answer 24

vague
bloating
burning
sharp

Question 25

causes of bloating

Answer 25

wind

flatulance

relaxation of abdominal wall muscles

mucus in stool

upper and other GI symptoms

Question 26

calprotectin

Answer 26

released by inflamed gut mucosa

used for differentiating IBS from IBD

Question 27

describe the bowel with regards to motility

Answer 27

its a muscular tube that squeezes content from one end to another

Question 28

what happens to bowel motility in IBS C vs D

Answer 28

C - muscular contractions may be stronger and more frequent than normal.

D - contractions reduced

Question 29

what can gut contractions be triggered by in IBS

Answer 29

walking

eating

Question 30

describe the brains involvement with the gut in IBS

Answer 30

the brain is able to hear messages from the gut such as hunger or the urge to go to the toilet

Question 31

what can influence IBS bowl

Answer 31

psychosocial

physiological