Gastro - malabsorption and inflammatory bowel disease Flashcards
general signs of malabsorption?
abnormal stools (can be difficult to flush) faltering growth specific nutrient deficiencies
coeliac disease - what are patients sensitive to
gliadin - from gluten - wheat, barley, rye
causes immunological response
coeliac disease - histological changes
short villi (atrophy) crypt hyperplasia
coeliac disease - presentation - when and how
present at 8-24 months faltering growth buttock wasting abdominal distension irritable foul smelling stools (short, anaemic, abdominal pain)
more likely to have diabetes etc
coeliac disease what investigations/markers are there
anti-tTG (tissue transglutaminase)
EMA - endomysial antibodies
biopsy
coeliac disease management
gluten free diet
risk of lymphoma in bowel if they dont
causes of nutrient deficiency
cholestatic liver disease/biliary atresia
lymphatic leakage/obstruction
short bowel syndrome
loss of terminal ileum function
exocrine pancreas function (cystic fibrosis etc)
intestinal cell absorption problems - ie coeliac etc
toddlers diarrhoea
chronic, non specific diarrhoea
varying consistency stools
in kids whats more common, crohns disease or ulcerative colitis?
crohns - unlike in adults where UC is more common
crohns disease overview
non caseating epithlial granuloma, transmural (all layers), can affect any part of the GI tract
can look like anorexia
crohns disease presentation
growth failure/delayed puberty abdominal pain diarrhoea weight loss fever lethargy \+ oral lesions, uveitis, arthralgia, erythema nodosum
investigations for crohns in kids
CRP, ESR Hb (low Fe)
albumin low
endoscopy/biopsy for diagnosis
treatment for crohns disease in kids
1 - polymeric diet
2 - systemic steroids
3 - methotrexate, azothiaprine, mercaptopurine
4 - infliximab
ulcerative colitis overview
mucosa of colon affected only rectal bleeding diarrhoea colicky pain weight loss, FTT erythema nodosum arthritis
investigations for ?UC
exclude infective colitis
endoscopy and biopsy
