GI Disorders

Question 1

Can you survive without a stomach?

Answer 1

Yes

Question 2

Can you survive without a small bowel?

Answer 2

No

Question 3

How many cm of combined jejunum and ileum do you need to achieve nutritional autonomy if there is no colon?

Answer 3

200cm

Question 4

How many cm of duodenum do you need to achieve nutritional autonomy if there is colon incontinuity?

Answer 4

100-150cm

Question 5

What is the definition of short bowel syndrome?

Answer 5

A symptom complex which occurs in adults who has < 200 cm of combined jejunum and ileum

Question 6

What physiological problems might you expect in patients with short bowel syndrome?

Answer 6

Malnutrition
Malabsorption
Weight loss
Diarrhoea
Dehydration

Question 7

Can you survive without a large bowel?

Answer 7

Yes

Question 8

What does bright red bleeding indicate?

Answer 8

Bleeding which is low in the colon or rectum

Question 9

What does darker red bleeding per rectum indicate?

Answer 9

A GI bleed which lies higher up in the GI system

Question 10

What is Melena?

Answer 10

Dark, tar like stool which indicates bleeding in the stomach

Question 11

What investigations can be done to identify a GI bleed?

Answer 11

OGD and colonoscopy

CT angiogram

Question 12

What might a OGDoscopy show?

Answer 12

Duodenal ulcer which is bleeding

Question 13

If the OGD shows too much blood, what does this indicate about the bleed?

Answer 13

The bleeding source is in the Upper GI tract

Question 14

If endoscopic measures fail to show the location of the bleed, what investigation should be done instead?

Answer 14

CT angiogram

Question 15

What is the treatment for a GI bleed?

Answer 15

Embolism of the bleed

Question 16

What treatment should be performed if embolism is unsuccessful?

Answer 16

Surgery to remove the bleed

Question 17

Which part of the GI system should you avoid embolising and why?

Answer 17

The large bowel as there is already not a very large blood supply- could cause ischaemia

Question 18

What is meant by cockily abdominal pain?

Answer 18

Pain in the abdomen which is associated with cramping pains, can come without warning and be quite intense

Question 19

What might a patient with a GI bleed present with?

Answer 19

Colicky pain, massive bright red bleeding per rectum, cold and clammy to touch, high heart rate and low blood pressure

Question 20

What is angiodysplasia?

Answer 20

Angiodysplasia of the colon is swollen, fragile blood vessels in the colon. This can result in blood loss from the gastrointestinal (GI) tract.

Question 21

What is Meckel’s Diverticulum?

Answer 21

small pouch / ulcer in the wall of the intestine, near the junction of the small and large intestines, which can rupture and cause sereve GI bleeding

Question 22

What are haemorrhoids?

Answer 22

Swollen veins in the lower rectum, which can bleed