Gastroenterolgoy Flashcards
What part of the GI system deals with iron and b12
Duodenum
What part of gi system deals with folate?
Jejunum
What part of the GI system deals with water?
Large intestine
What is the function of the pancreas?
Production of enzymes to digest food
Production of insulin
What is the function of the gall bladder?
Concentration and storage of bile
Fat digestion do and a absorption
What is the function of the liver?
Metabolism of nutrients and toxins
Production of bile
Protein synthesis
What are GI symptoms?
Pain
Dysphagia
Dysepsia
What are GI investigations?
Upper GI tract- endoscopy Lower GI tract- sigmoidoscopy, colonoscopy Radiographs Ultrasound MRI
Treatment for upper GI disorders re. Acid suppression
Antacids- aluminium hydroxide, calcium carbonate
Gastric acid reduction- h2 blockers- ranitidine, cimetidine
Proton pump inhibitors- omeprazole, lansoprazole
Treatment for upper GI disorders re. Anti emetics
Dopamine antagonists- domperidone, metoclopramide
Anti- histamines- cyclazine
Serotonin antagonist- ondansetron
What is GORD?
Gastro oesophageal reflux disorder
Excess acid at lower oesophageal sphincter
- loss of tone
- delayed gastric emptying
What is GORD associated with ?
Obesity
Lying flat
Fatty foods
Smoking
What are symptoms of GORD?
Heartburn
How is GORD diagnosed?
Endoscopy
Was is the treatment for GORD.
Change to lifestyle
Drugs- antacids, ppis
What is peptic ulcer disease?
Gastric
Duodenal
Caused by helicobacter pylori
NSAIDs
What are the symptoms of peptic ulcer disease?
Epigastric pain
Dyspepsia
Vomitting
Anorexia
What is tx for peptic ulcer disease?
Endoscopy
Acid suppression
Antibiotics re. Helicobacter
What is a hiatus hernia?
A structural abnormality of the stomach
May cause heartburn
Requires meds or surgery
What are dental aspects of upper GI disorders?
Caution with NSAIDS
oral ulceration with chronic blood loss
NCTSL- re. Acid reflux
What are some lower GI tract disorders?
Coeliac disease
Inflammatory bowel disease- crohns, ulcerative colitis
Diverticulitis
What’s are symptoms of coeliac disease?
Malabsorption: Malaise Diarrhoea Weight loss Iron and folate deficiency Protein deficiency
How is coeliacs diagnosed?
Endoscopy
Antibodies TTGA
What is treatment of coeliacs disease?
Gluten free diet
Osteoporosis prophylaxis
What should concern dentist re. Coeliacs disease?
Oral features of malabsorption
Bisphosphonates
Choice of drug prep
What are two inflammatory bowel diseases?
Crohn’s disease
Ulcerative colitis
What are symptoms of crohns?
Malabsorption
Abdominal pain
Bleeding
Oral manefeststions
What are symptoms of crohns and ulcerative colitis?
Bloody diarrhoea Abdominal pain Autoimmune arthritis Skin lesions Auto immune hepatitis Dvt and pe Ocular inflammation Cancer- long term complication
What are treatments for inflammatory bowel disease ?
5 aminosalicylic preps
Corticosteroids
Immunosuppressants
Biologics- anti Tnf agents
What are treatment for inflammatory bowel syndromes
Surgery - colectomy- uc, sections of bowels removed- crohns
Abscess drainage
Parented so nutrition and diet
Antibiotics
What is diverticulitis?
Lower GI tract disorder
Pouches or pockets on colon
What are common symptoms of functional GI disease?
Oesophageal- lump in throat
Gastric- dyspepsia
IBS- cramps, wind etc.
Treatment for functional gi disease
Fibre
Antispasmodics
Amytriptiline
What are causes of liver disease?
Alcohol Hepatitis viruses Iron overload- haemachromatosis Drugs Autoimmune Diabetes
Clinical features of liver, pancreas and biliary tract disease
Jaundice
Ascites- fluid in abdominal cavity
Telangiectasia- widened blood vessels
Renal failure
Clinical features of acute liver disease
Encephalopathy- confusion, impaired consciousness
Variceal haemorrhage- life threatening upper GI bleeding
Coagulopathy
Prone to infections
What are dental aspects re. Liver pancreas and biliary disease?m
Coagulopathy and reduced platelets- increase bleeding risk
Underlying infections- hepatitis
Be aware of effect of immunosuppressant if liver transplant
What GI disorders may cause dental erosion?
GORD
bulimia
What are patient with GI cancers more at risk of?
Oral cancers
What are oral manefeststions of Crohn’s disease?
Ulcers Facial swellings Labial swelling Cobblestone mucosa Mucosal tags Angular chelitis
What part of the GI system deals with alcohol and water
Stomach