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Gut Health And Disease Flashcards

1
Q

Role of gastrointestinal tract

A

Intake of food,
Absorption of water,
Removal of waste

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2
Q

Mediators of digestion

A

Enzymes,
Stomach acid,
Bile salts

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3
Q

Where is amylase secreted

A

Mouth,

Pancreas

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4
Q

Where is pepsin secreted

A

Stomach

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5
Q

Where is trypsin secreted

A

Pancreas

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6
Q

Where are lipases secreted

A

Pancreas

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7
Q

How much gastric juices are produced a day

A

2 litres

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8
Q

Components of stomach acid

A 
HCl,
Salts,
Pepsin,
Mucus,
Water,
Intrinsic factor,
Bicarbonate
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9
Q

Where are bile salts secreted from and stored

A

Secreted by hepatocytes,

Stored in gall bladder

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10
Q

Function of bicarbonate in stomach acid

A

Maintains pH 7 at gastric epithelium

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11
Q

Use of intrinsic factor in stomach acid

A

B12 absorption

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12
Q

How much water is absorbed back into the body from the small intestine

A

8 litres

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13
Q

What is the gut brain axis

A

Communication between gut and brain

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14
Q

What does the gut brain axis control

A 
Motility,
Nutrient uptake,
Hormone release,
Enzyme release,
Appetite regulation,
Vascular flow,
Immune cell activity,
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15
Q

What is the intrinsic innervation of the GIT

A

Neurones that only communicate within the GIT

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16
Q

What is the extrinsic innervation of the GIT

A

Neurones that are regulated by and connected to the vagus nerve

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17
Q

What are the 2 ganglionic plexi in the gut

A

Myenteric plexi,

Sub mucosal plexi

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18
Q

Which ganglionic plexus is between the longitudinal and circular muscle

A

Myenteric

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19
Q

Which ganglionic plexus is between the circular muscle and mucosa

A

Sub mucosal

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20
Q

Why are circular and longitudinal layers of muscle needed

A

Different types of stretch

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21
Q

What are cell bodies and neural endings in the Myenteric plexus primarily involved in

A

Contraction and relaxation

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22
Q

What are cell bodies and neural endings in the sub mucosal plexus primarily involved in

A

Absorption and secretion of neurotransmitters and factors involved in moving water+nutrients between lumen+mucosa

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23
Q

What connects different types of neurones

A

Interneurons

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24
Q

Which parts of the GIT are inner stem my the vagus nerve

A

Mouth to transverse colon

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25
What is extrinsic innervation of the GIT
Vagus nerve mediated communication between the gut and CNS
26
What do the central terminals in extrinsic innervation synapse to
Neurones of the nucleus tractus solitarus in the brainstem
27
Where is the largest microbial colony in the body
Colon
28
What is the gut microbiota linked to
Obesity Inflammation Neurodegeneration
29
What can affect makeup of the gut microbiota
Childhood diet Present diet Environmental factors
30
What happens to undigested food particles in the small intestine
Travel to colon and used by bacteria - starch, plant cell walls
31
What is the aim of faecal microbiota transfer
Increase microbial diversity
32
What types of donor can be used in FMT
healthy relative, Super donor, Artificially produced probiotics
33
FMT is approved for treatment of which disease
C Difficile
34
What causes rapid increases in C Difficile population
Opportunistic overgrowth due to broad spectrum antibiotics
35
Symptoms of C Difficile
Watery diarrhoea, | Abdominal pain
36
C Difficile treatment
Stop antibiotic use, Vancomycin, Metronidazole, FMT
37
What is a prebiotic
Substance that promotes growth and survival of bacteria and funghi
38
What food ingredients are pro biotics
Fructans, Galactans, Dietary fibres
39
What are probiotics
Live cultures in diary products and fermented foods which maintain normal microbial quorum
40
What are upper GI symptoms
``` Acid reflux, Nausea, Vomiting, Belching, Gastropariesis, Bloating ```
41
Lower GI symptoms
Bloating, Constipation, Diarrhoea, Abdominal pain
42
What is GERD
Gastroesophageal reflux disease - stomach contents move from fundus to distal oesophagus
43
What causes GERD
Frequent Transient lower eosophageal sphincter relaxations
44
Is GERD chronic or acute
Chronic
45
What can GERD lead to
Ulcer formation, Inflammation, Barratt’s eosophagus
46
GERD treatment
OTC - antacids, alginates | Prescription - proton pump inhibitors
47
How do proton pump inhibitors treat GERD
Block stomach acid production
48
What is gastroparesis
Delayed gastric emptying
49
What causes gastroparesis symptoms
Prolonged presence of food water and gastric juices in stomach
50
Gastroparesis symptoms
``` Nausea, Vomiting, Rapid feeling of fullness, Reflux, Pain, Bloating ```
51
What causes diabetic gastroparesis
Neuropathy of vagal endings enervating stomach
52
What can gastroparesis cause
Malnutrition, Bezoars, Blood sugar changes
53
How is gastroparesis diagnosed
Gastric emptying study
54
Proccess of a gastric emptying study
1) patient eats C13 labelled meal 2) C13 exhaled 3) C13 used as marker of food movement through stomach 4) time course values compared to normal values
55
Gastroparesis treatments
Domperidone/ erythromycin, Anti emetics, Dietary changes
56
What is inflammatory bowel disease
Collective term for chronic inflammation of lower GIT
57
Possible causes of inflammation bowel disease
Altered epithelial barrier integrity, Changes to microbial quorum, Gut brain interactions
58
What is Crohn’s disease
Chronic inflammatory disease which can effect whole GIT but is usually localised to small bowel
59
Active Crohn’s disease symptoms
``` Diarrhoea, Abdominal pain, Fatigue, Fever, Blood in stool, ```
60
Crohn’s disease effects
Epithelium damage, | Uncontrollled inflammation
61
What can Crohn’s disease lead to
Scarring of bowel epithelium, Bowel obstruction, Ulcers in mouth and peritoneum, Fistulas
62
How is Crohn’s disease diagnosed
Fecal calprotectin over 250ug/g, | Colonoscopy
63
Paediatric Crohn’s disease treatment
Enteral nutrition for 4 wks
64
Adult Crohn’s disease treatment
Corticosteroids, Azathioprine and mercaptopurine - immunosuppressants, Biological therapy - antibodies to neutralise TNF
65
What is ulcerative colitis
Chronic inflammatory condition in colon
66
Types of ulcerative colitis
``` Proctitis, Proctosigmoiditis, Distal colitis, Extensive colitis, Pancolitis ```
67
Active Ulcerative colitis symptoms
``` Bloody diarrhoea, Urgency, Abdominal pain, Fatigue, Fever, Weight loss ```
68
What causes ulcerative colitis
Damage to colonic epithelium causes ulcer like appearance of mucosa
69
What can ulcerative colitis lead to
``` Colon perforation, Severe bleeding, Dehydration, Systemic inflammation, Colon cancer ```
70
Ulcerative colitis diagnosis
Fecal calprotectin over 250ug/g, | Colonoscopy
71
Mild/moderate ulcerative colitis treatment
Aminosalicylates, | Corticosteroids
72
Severe ulcerative colitis treatment
Biological therapy - antibodies to neutralise TNF, ciclosporin iv Colectomy
73
What is IBS
Umbrella term for functional gastrointestinal diseases with a defined set of symptoms but unknown pathology
74
FGID symptoms in upper GIT
Functional GERD, Functional dyspepsia, Bloating, Pain
75
FGID symptoms in lower GIT
Abdominal pain, Cramping, Constipation, Diarrhoea
76
How is IBS diagnosed
ROME IV questionnaire
77
Possible brain related mechanisms for IBS
Pain, Emotions, Cognitions, Social behavior
78
IBS environmental influences
``` Stress, Early life adversity, Social support, Medical system, Diet, Pathogens, Antibodies ```
79
Possible IBS causes
``` Gastroenteritis, Leaky gut epithelium, Change to micro biome quorum, Visceral hypersensitivity, Abnormal activity of enteric neurones ```
80
IBS treatment
``` Diet changes - FODMAP, Treat specific symptoms, Lanaclotide, Lubiprostone, Rifaximin ```

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