Gastroenterology Flashcards
What is the GI tract lined with
Lines with mucosa from the mouth to the anus
Name some common gastrointestinal problems
- Inflammatory bowel disease
- IBS
- Colorectal cancer
- Haemorrhoids
- Diverticular disease
- Enteric infections
- Upper GI problems
Give examples of upper GI problems
- Dysphagia
2. PUD
What is inflammatory bowel disease (IBD)
A diverse collection of inflammatory disorders of the gastrointestinal tract
Give examples of soem IBDs
- Crohns disease
2. ulcerative colitis
Is inflammatory bowel disease fatal
Morbidity and mortality can be high
Describe the aetiology of IBD
- Environmental factors
- Genetic predisposition
- Host immune response
List some environmental factors for IBD
- Smoking
2. Depression
List some clinical features of IBD
- Diarrhoea
- Nocturnal symptoms
- Weight loss
- Fatigue
- Nausea/ vomiting
- Bloating and abdominal pain
- Perianal symptoms
- Genital symptoms
- Arthritidaes
- Skin lesions
- Eye disease
- Hepatobiliary disease
- Vascular disease
- Renal disease
- Pulmonary disease
16 Amyloidosis
How can we manage IBD
- Medical management
2. Surgical management
How can we medically manage IBD
- Corticosteroids
- Aminosalicylates
- Immunomodulatory drugs
- Biologic agents
How can we surgically manage IBD
- Resections
2. Stoma formation
What is coeliac disease
A gluten specific enteropathy
What oral presentation can patients with coeliac disease have
- Aphthae
- Dermatitis herpetiformis
- Angular chelitis
What can patients with coeliac disease have a higher change of developing
- IBD
- CRC
- Lymphomas
How do we manage coeliac disease
A lifelong gluten free diet is effective curative
How do we diagnose coeliac disease
- Blood tests to look for antigens that they are reacting to (anti TT)
- Upper GI endoscopy
List some risk factors of Colorectal cancer
1, Age
- Diet
- Colorectal polyps
- Colorectal cancer
- Tobacco
- Acromegaly
- abdominal radiotherapy
Give some clinical features of Colorectal cancer
- Altered bowel habit
- PR bleeding, tenesmus
- Symptomatic anaemia
- Rectal/ abdo mass
- Asymptomatic
How can we manage Colorectal cancer
- Tumour resection
- Possible stoma formation
- Adjuvant chemotherapy
- Radiotherapy not useful for bowel lesions
What does the prognosis of Colorectal cancer depend on
Depends on cancer stage and presence of metastasis
What is the common name of Colorectal cancer
Bowel cancer
How common is Colorectal cancer
4th most common caner
Is Colorectal cancer fatal
2nd biggest killer in the uk
At what age do you get sent a at home blood test for bowel cancer
60
What does the treatment of colorectal cancer depend on
Site of caner Dietary triggers
What are the benifets of adjuvant chemotherapy
improved disease free survival and overall survival in stage 3 cancer
When is radiotherapy not a useful treatment for colorectal cancer
When the cancer is proemial to the rectum
Why is radiotherapy not a suitable treatment for colorectal cancer when it is proximal to the rectum
As it would be difficult to administer a high enough dose without famafign adjacent structures eg small bowel
What are soem of the risks when removing colorectal cancer
- Bleeding
- Infection
- Blood clots
- Damage to nearby organs
- Leaking joints
What are some safe effects of rectal cancer surgery
Sexual dysfunction
Erectile dysfunction
Bladder function changes
What are stomas
Small pouches that can be connected to your digestive tract to help taste to be diverted out of the body
what are the disadvantages of stomas
1They may lead to feelings of shame or prevent intimate relationships, swimming etc
Name the most common GI presentation
Irritable bowel syndrome
What triggers irritable bowel syndrome
Dietary triggers
How much does IBS cost the NHS
£45.6 MILLION per year
List some associations of IBS
- Fibromyalgia
- Menstrual dysfunction
- Joint hyper mobility
- Anxiety
- Trauma
How can IBS affect a persons life
25% of patents with IBS take 7-13 days off work
How do we diagnose IBS
By symptom reading no physical exam
What requirement must be filled before we can diagnose a patient with IBS
In preceding 3 months they must have at least 3days/ mont of recurrent abdominal pain or discomforted associated with:
- Improvement with dedication
- Onset with change in frequency of stool
- Onset with a change in the appearance of stool
What do we need to rule out before diagnosing a patient with IBS
§. IBD
- CRC
- Enteric infection
How do we treat IBS
Explain the symptoms to the patient
No further treatment usually required just support and reassurance
Try to avoid dietary triggers and maintain high fibre diet