Gastrointestinal Risk Factors And Complications

Question 1

What are the risk factors for peptic ulcer?

Answer 1

NSAID use

Smoking

Alcohol excess

Family history of peptic ulcer disease

Physical stress (- trauma, surgery, ICU admission; stress ulcer)

Zollinger-Ellison syndrome (gastrin secretion excess increases acid production)

Question 2

What are the complications of peptic ulcer disease?

Answer 2

Perforation - erosion through wall of stomach/duodenum into peritoneal cavity (shock and peritonitis)

Penetration - erosion in to adjacent organ without perforation (e.g.pancreas)

Gastric outlet obstruction - pyloric stenosis due to scarring and oedema during ulcer healing (Nausea, vomiting, weight loss

Upper GI bleeding - NSAIDs in particular cause this because they damage endothelium and their antiplatelet properties prevent clotting (haematemesis, melaena, iron deficiency anaemia - Fatigue, Dyspnoea, palpitations)

Question 3

What are the risk factors for development of diverticuli?

Answer 3

High intake of meat 
Chronic constipation
Increasing age
Hereditary factors
Low fibre diet

Question 4

What are the complications of diverticuli?

Answer 4

Diverticulitis - infection of the diverticulum and post-infective strictures

Bleeding per rectum - occult or overt (often sudden and painless)

Perforation causing peritonitis

Abscess formation

Fistulae - new connection between colon and small intestine/vagina/bladder (enterocolic, colovaginal, colovesical)

Question 5

What are the complications of acute appendicitis?

Answer 5

Perforation - common with faecolith

Appendix mass - inflamed appendix becomes covered in omentum and they adhere to oneanother

Appendix abscess - the result of an unresolved appendix mass

Question 6

In which page group is mesenteric ischemia more prevalent?

Answer 6

The elderly

Question 7

What are the risk factors for intussusception?

Answer 7

Male sex

Age 6-12 months; a mostly paediatric condition
Rarely occurs in adults