gastrointestinal system Flashcards
what is crohn’s disease
inflammation in the bowel = discontinuous = can be in any area
Rectum involved 50% of time = anal fissures 75% of time
Ileum involved 30%
Mucosa cobbled & fissures
Non vascular (oedematous)
Serosa Inflamed
Same as UC
causes OROFACIAL GRANULOMATOSIS (lymph blocks) in the mouth
symptoms: diarrhoea, stomach aches and cramps
ulcerative collitis
continuous inflammatory disease through the colon
rectum always involved too
mucosa granulomatous & ulcerated
vascular
serosa normal
symptoms: diarrhoea, abdominal pain, rectal bleeding
anal fissures 25%
ileum involved 10%
what can cause vitamin B12 and Fe malabsorption?
Coeliac disease
α-gliadin in gluten sensitivity where the α-gliadin reacts with the jejunum causing villous atrophy.
Symptoms
○ Weight loss
○ Aphthae
○ Lassitude
○ Weakness
○ Diarrhoea or steatorrhoea (fatty poo)
○ Abdominal pain
Test for
○ Fat in stool
○ Check haematinics
○ Check response to a gluten free diet
Gastric Disease (Peptic Ulcer Disease - PUD)
Can affect the oesophagus, stomach or duodenum.
Causes
■ Increased stomach acid production
■ Reduced protective barrier
● (Helicobacter Pylori involvement)
stress !
Triple therapy of
■ 2 antibiotics = amoxycilin + metronidazole
■ 1 Proton Pump Inhibitor = Omeprazole
Signs and Symptoms
■ Asymptomatic
■ Epigastric burning
Investigations
■ Test for anaemia
■ Test for H. Pylori (breath, antibodies and mucosa)
■ Barium meal
■ Endoscopy
Treatments
■ Change lifestyle
■ Eradication therapy
■ Stricture removal
■ Vagotomy
what pattern of dental erosion would be seen in patient with GORD?
Erosion on lingual surfaces of anterior teeth
what 2 changes be seen in oesophagus?
ulceration
inflammation
change from stratified squamous epithelium to simple columnar with goblet cells = Barrett’s oesophagus
1 medical and 1 surgical treatment of GORD
Stop smoking!
Lowering weight
antacids, H2 blockers, proton pump inhibitors (PPIs)
cause and consequences of GORD?
gastro-oesophageal reflux disease.
Due to a defective lower sphincter
Leads to impaired clearing and gastric emptying
Causes inflammation, ulcerations and metaplasia (Lower oesophagus mucosa changes to stomach lining mucosa)
barrett’s oesophagus
Signs and symptoms of GORD
Burning of the epigastric region
Worse when lying down, bending and birth giving.
Dysphagia
GI bleeding ∴ anaemia
medications that can cause peptic ulcer disease?
NSAIDs and steroids
risk factor for pud?
smoking, alcohol, spicy foods, stress
symptoms of peptic ulcer disease
- Epigastric burning pain after eating, before eating
- Pain worse at night
- Pain relieved by alkali
List 3 key clinical or pathological features of Crohn’s disease
Crohn’s disease features mucosal discontinuity, transmural involvement, and granulomas
HEALTHY PARTS MIXED WITH NON HEALTHY
CAN OCCUR IN ALL LAYERS OF THE BOWEL WALLS
Persistent diarrhoea, rectal bleeding
List 3 key clinical or pathological features of Ulcerative colitis
diarrhea, passage of mucus, passage of bloody mucus, bloody diarrhea, and crampy pain
crypt cells branching and irregularity of size and shape
CONTINOUS INFLAMMATION OF THE COLON
MOSTLY AFFECTS INNER LAYER
