GI Flashcards
what is coeliac disease?
chronic inflammation of the small intestine
Symptoms:
diarrhoea, bloating, abdo pain
what is coeliac disease caused by?
adverse reaction to gluten
Gluten is found in cereals, wheat, barley, rye
what are the treatment options for coeliac disease?
gluten-free diet
vitamin and mineral supplementation
assess for risk of osteoporosis and treat
what are people with coeliacs disease at risk of develpoing?
malabsorption of key nutrients (vitamin D and calcium) leading to osteoporosis
what are diverticula?
small pockets/ bulges that develop on the lining of the intestine?
what is diverticular disease?
diverticula present
symptoms:
abdo pain, constipation, diarrhoea, rectal bleeds
what is acute diverticulitis and what can this lead to?
diverticula become inflamed/ infected
symptoms include sever abdo pain, fever, rectal bleeding
can lead to complicated acute diverticulitis:
abscess, perforation, fistula, obstruction, haemorrhage, sepsis
how can you treat diverticular disease?
high fibre diet
bulk forming laxatives
paracetamol
ABX - diverticulitis
what are the two types of IDB?
crohn’s & UC
what is crohn’s?
inflammation of the GI tract from mouth to anus
what are the symptoms of crohn’s?
abdo pain, diarrhoea, rectal bleeding, weight loss, low grade fever, fatigue
what are the complications of crohn’s?
malnutrition, anaemia, cancers, arhritis, intestinal strictures/ abscesses/ fissures
what lifestyle advice can be given to patients with crohn’s?
high fibre diet
smoking cessation - reduces risk of relapse
what options are available to treat diarrhoea associated with crohn’s?
loperamide
codeine
cholestyramine
what is the treatment options for a patient with crohn’s who presents with their first flare up in 12 months?
prednisolone, methylprednisolone, IV hydrocortisone
what is the treatment options for a patient with crohn’s who has had 2 or more flare ups in the past 12 months?
1st azathioprine/ mercaptopurine
2nd methotrexate
if severe - MABs
what treatments can be used to manage maintenance of remission in crohn’s?
1st azathioprine/ mercaptopurine
2nd methotrexate
what medications should be initiated for maintenance of remission of crohn’s following surgery?
azathioprine + metronidazole
what is UC?
inflammation and ulcers affecting colon/ rectum
symptoms:
bloody diarrhoea (mucus or pus), abdo pain, urgent need to defecate
Acute flare up: mouth ulcers, arthritis, sore skin, weight loss, fatigue
what are the complications of UC?
colorectal cancer, osteoporosis, VTE, toxic megacolon
can loperamide and codeine be used to treat diarrhoea in acute flare up of UC?
No
can cause paralytic ileus - increased risk of toxic megacolon
what are the different types of UC?
extensive (proximal) - affects entire colon
left sided (distal) - inflammation up to distal colon
proctosigmoiditis - inflammation of rectum and sigmoid colon
proctitis - inflammation of rectum
*treatment depends on area affected
how would you treat an acute mild/ moderate flare up of UC?
proctitis:
1st topical aminosalicylate for 4 weeks, if not improved THEN
2nd oral aminosalicylate
3rd corticosteroid for 4-8 weeks
proctosigmoiditis:
1st topical aminosalicylate for 4 weeks, if not improved THEN
2nd + oral aminosalicylate
3rd + corticosteroid for 4-8 weeks
extensive (proximal and distal):
1st topical + oral aminosalicylate
2nd + corticosteroid for 4-8 weeks
how do you treat a severe acute flare up of UC?
IV corticosteroid
if symptoms don’t improve/ worsen in 72 hour:
IV ciclosporin + IV corticosteroids
OR surgery
