Gastrointestinal Disease Flashcards
What are the main defences of the gastrointestinal tract against acid production?
Mucous production Bicarbonate production in pancreas Prostaglandin production Tight junctions gastric epithelial regeneration
Where are peptic ulcers most commonly found?
distal stomach and proximal duodenum
How does H. Pylori cause peptic ulcerations?
breaks mucous layer
produces a high pH buffer against acidic environment
adheres to gastric epithelial cells
What are the main physical results post H. Pylori infection?
Reduces pH - enhances gastric acid secretion/impairs bicarbonate production
Secretes toxins which damage epithelium and weakens tight junctions
Promotes inflammatory response
What are the main complications/outcomes associated with chronic peptic ulcers?
- Healing
- Bleeding - small or large bleeds
- Perforation - ulcer penetrates wall completely
- Obstruction - intestinal contriction/blockage during healing
What are the treatments currently offered for peptic ulcers?
antibiotics - removal of bacterial cause
decrease in NSAIDs
reduce acid secretions
surgery
What is GORD?
Gastro-oesophageal reflux disease
What are the pathology and symptoms related to GORD?
Damage to mucosa due to lower oesophageal sphincter (LOS) dysfunction
Inflammation, ulceration of luminal surface
What other complications can arise due to GORD?
- Stricture/oesophageal damage
2. Barrett’s oesophagus
Which treatments are offered for GORD?
Ant-acids
Proton pump inhibitors
Histamine receptor inhibitors
surgery
Describe the pathology related to Coeliac disease
Auto-immune disease - antibodies againt gluten
Immunoglobulins attack the villi within the small intestine
inflammatory response of mucosal surface is activated
atrophy of villi = decreases surface area = decreased absorption
What are the symptoms associated with Coeliac disease?
diarrhoea, fatigue, abdominal pain, weight loss, flatulence
What percentage of Coeliac disease remain asymptomatic?
38% of cases are asymptomatic
What are the natural defences against gastrointestinal infection?
Stomach acidity epithelial barrier enterocytes constantly replenished colonisation resistance bacteriocins
Compare and contrast infection and intoxication
Infection is the invasion of the body by a live pathogen, disease takes a longer time to develop, fever is a common symptom, blood and mucous is present in diarrhoea
Intoxication is ingestion of toxin produced by bacteria/pathogen (NOT BACTERIA ITSELF)
Fast onset of sickness, fever is not typically a symptom, no blood or mucous within diarrhoea.
What are the two types of IBD and how do they differ?
- Ulcerative Colitis - ulcers which are located on the mucosa in ‘sheets’
- Crohn’s disease - deep lesions which can occur anywhere on the mucosa (eyes, mouth, etc.)
What are the treatments offered for IBD?
Immune suppressors
Neutralising antibodies
Microbiota transplant
Surgery
Compare and contrast immune suppressors and neutralising antibodies.
immune suppressors have a non-specific effect on the immune system
neutralising antibodies have a targeted approach to specific components of the immune system to decrease the autoimmune response.
What is the pharmacology related to colon cancers?
longer transit time and decreased water content of foods transported within the lumen can expose the muscosa to potentially carcinogenic substances. A greater risk of mutations occurring which could cause proliferative complications = cancer
What are the treatments available for colon cancer?
Depends on the type, grade and stage of the cancer as well as the general health of the patient at diagnosis
