GI 4 Flashcards
4 important organs of the GI tract
- esophagus
- stomach
- small intestine
- colon
esophagus function
transport food entering mouth to stomach
stomach role
digestion, some absorption
small intestine role
absorption and digestion
different micornutrients absorbed in different parts
colon role
fluid/electrolyte absorption
propulsion/holding feces
vitamin produciton (gut microbiome)
GERD =
gastroesophageal reflux disease
GERD is characterized by
- transient lower esophageal sphincter relaxation
- increased intra-abdominal pressure
dietary triggers of GERD
caffeine
alcohol
lifestyle risk factors for GERD
obesity
pregnancy
exercise after eating
GERD pathophys
increased exposure of esophageal mucosa to __
impacts local microbiome and stimulate __ response
increased intracellular __
GERD pathophys
increased exposure of esophageal mucosa to gastric contents
impacts local microbiome and stimulate immune response
increased intracellular permeability
IBD = __ immune dysregulation due to interaction between __ microbiota and __ immunity
IBD = mucosal immune dysregulation due to interaction between intestinal microbiota and host immunity
IBD genetics
host must be genetically susceptible
IBD diagnosis
- symptoms (dermatological, vascular, respiratory, inflammatory)
- exams, stool tests, imaging, biopsy
IBD diagnosis requires high __ (detects inflammation) and low __ (tells us you are in active IBD)
IBD diagnosis requires high calprotectin (detects inflammation) and low albumin (tells us you are in active IBD)
IBD: __ immune defects involving __ receptors
IBD: innate immune defects involving pattern recognition receptors
IBD also has __ dysfunction that affects __
IBD also has epithelial barrier dysfunction that affects mucus secretion, peristalsis, antimicrobial factors
IBD also has __ immunity defects
IBD also has adaptive immunity defects
goal of IBD treatment
mucosal healing
absence of ulcerations and erosions
pharmacotherapy for IBD
- steroids (short-term)
- aminosalicylates (UC only)
- immunosuppressants
- biologics
what types of remission must we achieve with IBD
clinical, serologic, endoscopic remission
step-up therapy:
top-down therapy:
step-up therapy: nutrition, probiotics, start with antiobiotics, go up to more severe treatments
top-down therapy: start with surgery, supplement with simpler treatment options
is current approach to IBD step-up or top-down?
top-down!
anti-__ meds are effective in treating IBD
anti-TNF meds are effective in treating IBD
dietary approaches to treat IBD
- specific carbohydrate diet (SCD)
- Crohn’s disease exclusion diet (CDED)
- exclusive enteral nutrition (no solid foods)
what diet is really bad for IBD?
low fiber with food additives increase risk
IBS is __, __ abdominal pain with altered __
IBS is chronic, recurrent abdominal pain with altered bowel habits
prevalence of IBS
10-15%
IBS makes up __% of referrals to GI
IBS makes up 25-50% of referrals to GI
__ is the most common funcitonal GI disorder
IBS is the most common funcitonal GI disorder
8 parts of IBS pathophys
- dysregulated gut motility
- visceral hypersensitivity
- inflammation
- postinfections
- microbiome
- food sensitivity
- genetics
- psychosocial dysfunction
IBS inflammation
some patients have increased __ cells/__ and increased __
IBS inflammation
some patients have increased inflammatory cells/cytokines and increased permeability
IBS and psychosocial dysfunction
correlation with traumatic life events
higher rates of mood disorder, suicidal ideation, anxiety
IBS food sensitivities
fructose
fructans
gliadin
sorbitol
lactose
