Functional GI Disorders Flashcards
describe functional GI disorder
- no detectable pathology
- related to to gut function
prognosis of functional GI disorders
long term prognosis
types of functional GI disorders
oesophageal spadm
non-ulcer dyspepsie
biliary dyskinesia
IBS
slow transit constipation
drug related effects
how are the majority of functional GI disorders diagnosed
history
examination
nausea
the sensation of feeling sick
retching
dry heaves
Antrum contracts, glottis closed
vomiting
contents expelled
chemoreceptor trigger zone function
detects changes in the body and communicates them to the vomiting centre to initiate vomiting
factors that can tigger vomiting centre
- receptors for opiates
- digoxin
- chemotherapy
- uraemia
type of cause if vomiting occurs immediately after eating food
psychogenic
type of cause if vomiting occurs 1 hour after eating food
- pyloric obstruction
- motility disorders
type of cause if vomiting occurs
12+ hours after eating food
obstruction etc.
functional causes of vomiting
drugs
pregnancy
migraine
cyclic vomiting syndrome
alcohol
psychogenic vomiting features
- often young women
- often for years
- no preceding nausea
- self induced?
- Appetite usually not disturbed but may lose weight
- often stops shortly after admission
functional diseases of lower GI tract
IBS
slow transit constipation
physical examination for functional disease
- look for systemic disease
- careful abdominal examination
- rectal examination
assessing patient ALARM symptoms?
- 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
investigations for functional disease
- FBC
- Blood glucose
- U+E
- Thyroid status
- Coeliac serology
- FIT testing
- sigmoidoscopy
- colonoscopy
primary aetiologies of constipation
- systemic
- neurogenic
- organic
- functional
organic aetiology of constipation
- strictures
- tumours
- diverticular disease
- proctitis
- anal fissure
functional aetiology of constipation
- megacolon
- idiopathic constipation
- depression
- psychosis
- institutionalised patients
systemic aetiology of constipation
- diabetes mellitus
- hypothyroidism
- hypercalcaemia
neurogenic aetiology
- autonomic neuropathies
- parkinsons
- strokes
- multiple sclerosis
- spina bifida
types of abdominal pain
vague
bloating
burning
sharp
causes of bloating
wind
flatulance
relaxation of abdominal wall muscles
mucus in stool
upper and other GI symptoms
calprotectin
released by inflamed gut mucosa
used for differentiating IBS from IBD
describe the bowel with regards to motility
its a muscular tube that squeezes content from one end to another
what happens to bowel motility in IBS C vs D
C - muscular contractions may be stronger and more frequent than normal.
D - contractions reduced
what can gut contractions be triggered by in IBS
walking
eating
describe the brains involvement with the gut in IBS
the brain is able to hear messages from the gut such as hunger or the urge to go to the toilet
what can influence IBS bowl
psychosocial
physiological
