Functional GI Disorders Flashcards
What is a functional GI disorder?
Loss in gut function with no detectable underlying pathology
What are the functional GI disorders?
Oesophageal spasm Non-ulcer dyspepsia Biliary dyskinesia Irritable bowel syndrome Slow transit constipation Drug related effects
What is non-ulcer dyspepsia? How can it be diagnosed?
Treatment?
Dyspeptic type pain but no ulcer on endoscopy
Do a history for diagnosis - H. Pylori status? FH of gastric cancer? Alarm symptoms?
If all negative then treat symptomatically - if doubt then endoscopy
How do you assess causes of vomiting?
History - what length of time after food?
Immediate - psychogenic cause
1+ hours - pyloric obstruction? Motility issues?
12+ hours - obstruction
Functional causes of nausea & vomiting?
Drugs Pregnancy Migrane Cyclical vomiting syndrome Alcohol
Who is at risk of psychogenic vomiting? How does it tend to progress?
Usually young women. Often overlaps with bulimia (self induced)
Often stops shortly after admission
How to approach history of changes in gut function?
Need to establish a baseline - lot of variation in stools/day etc.
“What is normal for you?”
For functional disorders of the bowels what is important for diagnosis?
Rule out possible structural disease
Do this via history mostly - if any worrying FH, or signs/symptoms then do investigations
Functional causes of constipation?
Depression
Psychosis
Institutionalization
Clinical features of irritable bowel syndrome?
Abdominal pain (rarely at night) Altered bowel habit Abdominal bloating Belching and flatus (gas in stomach/intestine) Mucus Often improves with defaecation
Examples of altered bowel habit?
Constipation
Diarrhoea
Variability
Urgency
Good way of distinguishing IBD and IBS?
Calprotectin levels
Main treatment for IBS?
Dietary suggestions - FODMAPS diet
Psychological interventions
Possible cause of IBS diarrhoea and constipation?
Irregular contractions of the smooth muscle in the bowels (too much - diarrhoea, too little - constipation)
Effect of stress on people with IBS?
People with IBS usually more sensitive to abnormal digestive processes - can be induced by stress
Eg. They feel butterflies much more bc their gut is more susceptible to stress than a normal persons
