Gastroenterology Flashcards
What is the function of the gut
Digestion and absorption of nutrients
What is the gut composed of
Stomach
Duodenum
Jejunum
Large intestines
What are the two sections of the pancreas and what do they produce
Exocrine - enzymes to digest food
Endocrine - insulin
What is the function of the gal bladder
Concentrated and stores bile
What is the function of the liver
Metabolism of nutrients and toxins
Production of bile
Protein synthesis
What is dysphagia
Difficulty swalloing
What is dyspepsia
Discomfort relating to the upper GI tract
eg. heart burn
What are some symptoms associated with GI upset
Nausea/vomiting Diarrhoea Constipation Steatorrhoea - pales bulky stools Bleeding
How can you tell if a patient has bleeding from the upper GI tract or the lower GI tract
Bleeding from the lower GI tract tends to be fresh blood, bleeding from the upper GI tract tends to be dark and sticky in the faeces
How is the upper GI tract investigated
With an endoscopy
How is the lower GI tract investigated
Sigmoidoscopy or colonoscopy
Name 2 antacids
Aluminium hyrdoxide
Calcium carbonate
What are two kinds of gastric acid reduction meds
Histamine receptor antagonist
Proton pump inhibitor
Name 2 proton pump inhibitors
Omeprazole
Lansoprazole
What does the medication selected depend on
The cause of the condition
What does GORD stand for
Gastro-oesophageal reflux disease
What is GORD
Excess acid at the lower oesophageal spincter
What is GORD associated with
Obesity
Fatty foods
Lying flat
Smoking
How is GORD treated
Life style changes
Drugs - antacids / PPIs
Rarely surgery
Where can peptic ulcers occur
Stomach or Duodenum
What % of the population are affected by peptic ulcers and what age range / sex
15-20%
elderly men
What are two causes of peptic ulcers?
Helicobacter pylori
NSAIDs
What are the symptoms of a peptic ulcer?
Epigastric pain
Dyspepsia
Vomiting
Anorexia
What investigations can be done in relation to a peptic ulcer?
Endoscopy
Biopsy if gastric
What is the treatment for a peptic ulcer?
Acutely - stop bleeding / rarely surgery
Non acute - Acid suppression / treat helicobacter pylori
What is a hiatus hernia?
Structural abnormality of the stomach
What does a hiatus hernia cause?
Heart burn
How is a hiatus hernia treated?
With medication or surgery
What is coeliac disease?
Auto immune disorder of the small intestine
What are the symptoms of coeliac disease?
Malabsorption Malase Diarrhoea Weight loss Iron and folate deficiency Protein deficiency
How is coeliac disease diagnosed?
Blood test testing for TTGA antibodies
Endoscopy with a biopsy
How is coeliac disease treated?
With a gluten free diet
Osteoporosis prophylaxis
What are the two main forms of inflammatory bowel disease?
Crohns disease
Ulcerative colitis
What is the difference between crohns disease and ulcerative colitis?
Crohns is clumps of inflammation and ulcerative colitis is continuous inflammation
What are the symptoms of crohns?
Malabsorption Abdominal pain Oral features Bleeding Abscess
What are the symptoms of ulcerative colitis?
Bloody diarrhoea
Abdominal pain - less than crohns
How is crohns and ulcerative colitis diagnosed?
Radiology
Colonoscopy and biopsy
Stool sample
Clinical
How is inflammatory bowel disease treated?
Suppress the inflammation with corticosteroids or immunosuppressants
Surgery to remove diseased part of bowel
Parenteral nutrition / elemental diet
Antibodies
What is functional GI disease?
Symptoms with out demonstrable disease
What are some caused of functional GI disease?
Psychological
Altered bowel smooth muscle tone
High CHO diet
How is functional GI disease treated?
Reassurance
Fibre and other diet changes
Anti spasmodics
Amitriptyline
What is the name given to acute liver inflammation and the name given to chronic liver inflammation
Acute - hepatitis
Chronic - cirrosis
What are the causes of liver disease?
Alcohol
Viruses - hep A B C D E
Iron overload
Drugs
Auto immune - primary binary cirrhosis
chronic active hep
Diabetes
CryptogenicWhat are the clinical features of liver, pancreas and bilary tract disease?
Jaundice Ascites (increase free fluid in abdomen) Telangiectasia (failure to break down female hormone) Renal failure Encephalopathy (confusion and impaired consciousness) Variceal haemorrhage Coagulopathy Prone to infection
How is liver, pancreatic and bilary tract disease treated?
Remove and treat underlying cause
Supportive
Liver transplant
What are the symptoms of gall stones?
Pain
Jaundice
Pancreatitis
What is the cause of pancreatitis
Gall stones
Alcohol / drugs
How is pancreatitis treated
With supportive tx
What are the signs of upper GI bleeding
Haematemesis - fresh blood
Rectal bleeding
