GI slides 3

Question 1

Cause of IBS

Answer 1

No exact cause, but it has been associated with altered bowel motility (gut that moves faster, or slower or even tends get spasms) and could be due to stress

Question 2

Defining characteristics of IBS

Answer 2

• alternating diarrhoea & constipation w abdominal cramping in the absence of any identifiable GI tract pathology
• slow wave activity of the colon is markedly increased

Question 3

Some symptoms of IBS

Answer 3

• abdominal pain
• mucus in stool
• diarrhoea
• constipation
• bloating

Question 4

Medical management of IBS

Answer 4

• anti-diarrhoeal agents

- anti-spasmodic meds: to prevent further diarrhoea

Question 5

Nursing management of IBS

Answer 5

• adequate fluid & fiber
• diet: avoid oily food, alcohol, milk products, coffee, green beans
• stress management
• complementary med

Question 6

What are haemorrhoids

Answer 6

they are abnormally enlarged and inflammed blood vessels in and around the anus and lower rectum

Question 7

Internal haemorrhoid vs external haemorrhoid

Answer 7

Internal:

1. painless
2. has the ability to extend and protrude– can exacerbate & cause irritation

External:

1. painful/uncomfy
2. outside skin erodes; can cause itchiness & irritation

Question 8

Management of haemorrhoids

Answer 8

• increase fiber in diet (eg. beans, wheat, fruits)
• exercise
• Sitz bath
• haemorrhoid creams
• treat the clot (for external haemorrhoids)
• rubber band ligation, haemorrhoidectomy, stapled haemorrhodopexy

Question 9

_____ is the most common complication of haemorrhoids

Answer 9

Haemorrhage

Question 10

Acute appendicitis is the inflammation of the _________

Answer 10

vermiform appendix

Question 11

Causes of acute appendicitis

Answer 11

• fecalith obstructing the appendiceal lumen

- less common: due to lymphoid hyperplasia or parasitic worms

Question 12

Acute appendicitis can lead to ______→________→_______

Answer 12

appendix necrosis → abscess formation → death

Question 13

Describe the pain in acute appendicitis

Answer 13

1. vague pain in the epigastric/periumbilical area

2. aft 2-12 hrs, pain localises to the right lower abdominal quadrant & becomes colicky

Question 14

Is there rebound tenderness in acute appendicitis? And why?

Answer 14

Yes. Due to spasm of overlying abdominal muscles

Question 15

What can confirm acute appendicitis?

Answer 15

Ultrasound or CT scan

Question 16

Treatment of acute appendicitis

Answer 16

surgical removal of appendix

Question 17

Intestinal obstruction is more common in the _______

Answer 17

small bowel/ small intestine

Question 18

Causes of intestinal obstruction

Answer 18

• abdominal surgery with adhesions
• congenital abnormalities of the bowel
• carcinoma (primary, metastatic)

Question 19

Desc the process of the intestinal obstruction

Answer 19

obstruction causes gas & fluid accumulation → distention (pain) → water & electrolytes secreted into obstructed lumen of small intestine → venous return impeded → oedematous bowel wall → bowl wall absorptive capacity decreases → leakage to peritoneum / ischemia of bowel wall

Question 20

In intestinal obstruction, bacteria may translocate to ____. This causes _____.

Answer 20

bacteria may translocate to bloodstream. This causes fever & sepsis.

Question 21

In intestinal obstruction, blood escapes from engorged veins → blood & plasma loss → _____

Answer 21

shock

Question 22

Complications of intestinal obstruction

Answer 22

• peritonitis

- perforation

Question 23

Management of intestinal obstruction

Answer 23

• remove source of mechanical obstruction → surgery
• decompression
• fluid & electrolyte replacement