GI Disorders Flashcards
What are causes of vomiting?
- Blood-born drugs & toxins (dirty food, alcohol overdose)
- Vestibular apparatus (motion sickness)
What occurs during vomiting?
-Net blood loss of H2O’
(Drop in BP, low tissues blood perfusion, low oxygen and nutrient delivery, low removal of CO2)
-Alkalosis (pH > 7.45)
(Acid loss, blood accumulation of HCO3, decrease in enzyme functions)
What are treatments of diarrhoea?
- Fluids replacement (electrolytes)
- Diet: starch & simple proteins
- Opium-like drugs
What is GIT motility increased by?
- Abnormal nerve activity (affects rate of water absorption)
- Osmotic effect of luminal contents (e.g. increased water-retaining substances)
How is IBS diagnosed?
Symptoms at least once a week in the last in the last 3 months + 2 of below
- Pain (defecation)
- Associated with change in stool frequency
- Associated with change in stool form
How is IBS treated?
- Manage stress
- Adequate fibre intake (avoid fat, gas-producing food, alcohol & caffeine)
- Antispasmodic and anticholinergic drugs
What is osmotic diarrhoea?
- Ingestion of poorly absorbed substrate e.g. lactose
- Produces gas resulting in pain and flatulence
- Stops when patient stops consuming the poorly absorbed solute
What is the mechanism behind constipation?
GIT flow rate decreases, contact time of contents in lumen increases, increased absorption of water and ions
What are 2 causes of constipation?
- Insufficient intake of fibre/ water retaining substances
- Weakness of abdominal muscles e.g. inactivity + pregnancy
What does the stomach secrete?
- Pepsinogen: inactive form of pepsin
- Hydrochloric acid: antimicrobial and activation / conversion of pepsinogen
- Mucus: protection of the mucosa
What is peptic ulcer disease?
-Break/ ulceration in mucosal lining
What are the 2 types of peptic ulcers?
- Duodenal
- Gastric
What are superficial ulcers called?
Erosions (erode only the mucosa)
What are true ulcers?
Erode through the muscularis mucosa or even deeper into submucosa
What can true ulcers do?
- Damage blood vessels causing haemorrhage
- Perforate the gastro wall
What is the primary defect of duodenal ulcers?
-Hypersecretion of acid and pepsin from the stomach
What are causes of duodenal ulcers?
- Long term use of NSAIDs
- Helicobacter pylori infection of gastric / duodenal mucosa
- Irregular meal time
- Alcohol
- Smoking
What are symptoms of duodenal ulcers?
- Chronic intermittent pain
- Empty stomach pain (2-3hrs after eating)
- “Pain-food-relief” pattern: ingestion of food + antacids relieves the pain
- Bleeding causing hematemesis + melena
What do asymptomatic duodenal ulcers indicate?
First sign may be a haemorrhage / perforation
How is duodenal ulcers diagnosed?
endoscopy, urea breath test
How is duodenal ulcers has to be treated?
Acid suppressors
Antibiotics
What is the primary defect of gastric ulcers?
Abnormality that increases the permeability of the gastric mucosa to hydrogen ions
What are symptoms of gastric ulcers?
- Epigastric pain immediately after eating
- Chronic
- Vomiting + weight loss
- Cancerous
What is jaundice caused by?
Hyperbilirubinemia
What are the 3 stages of hepatitis type A?
- prodromal (abrupt / insidious)
- Jaundice
- Convalescent
What does the exocrine pancreas do?
Releases digestive juices through a duct to the duodenum
What does the endocrine pancreas do?
Releases hormones into the blood
What do acini produce?
Inactive digestive enzymes and bicarbonate
What is acute pancreatitis?
Sudden and severe inflammatory reaction to an acute irritant which activates and releases pancreatic enzymes
What is the causes of acute pancreatitis?
Gall stone, beer BBQ
How is acute pancreatitis diagnosed?
Lab: ELEVATED serum amylase + lipase
CT scan
What is the treatment for acute pancreatitis?
Pain relief
Fasting
IV fluids
antibiotics
