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Metabolism > Gut health and Disease > Flashcards

Gut health and Disease Flashcards

1
Q

Which enzymes does the pancreas produce?

A

trysin, amylases & lipases, protease

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2
Q

Which cell produces bile salts? Where are bile salts stored?

A

Hepatocytes

Gallbladder

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3
Q

What does the enteric nervous system do in the gut?

A 
Motility 
Nutrient uptake
Hormone and enzyme release 
Appetite regulation
Vascular flow
Immune cell activity
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4
Q

What is the intrinsic innervation of the gut? What mediates this?

A

Intrisnsic innervation- communication within the gut only

Mediated by ganglionated plexi: myenteric (longitudinal and circular muscle) and submucosal plexi (circular muscle and mucosa)

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5
Q

Which nerve mediates communication between the gut and CNS? Which nucleus does it synapse with for this?

A

Vagus

Central terminalis synapses with nucleus tractus solitarus.

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6
Q

What part of the GI tract does the vagus nerve innervate?

A

Mouth- transverse colon

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7
Q

Where is gut microbiota found?

A

Colon

some in small intestines

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8
Q

What can an abnormal gut microbiota cause?

A 
IBD (inflammation)
and IBS (non-digestible carbohydrates)
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9
Q

What is the purpose of Faecal Microbiota Transfer? What condition is it approved to treat?

A

Increase microbial diversity
Donors: Healthy relative, ‘super donors’ or artificially produced probiotics
Only approved for treatment of C.difficile infection following failure of antibiotic therapy

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10
Q

What does Clostridium difficile do to the gut? How does it occure? what are the symptoms? How is it treated?

A

Effect- changes to the microbiome
Cause- broad-spectrum antibiotic (opportunistic)

Symptoms- watery diarrhoea, abdominal pain
Treatment-
1. Stop antibiotic use
2. Vancomycin or metronidazole

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11
Q

What is the function of pre-biotics?

Which bacteria does it help promote

A

promote growth and survival of bacteria

Stimulate Bifidobacterium & Lactobacillus

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12
Q

Give some examples of pre-biotics

A

Non-digestible food ingredients-
Fructans
Galactans
Dietary fibres

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13
Q

What are probiotics?

A

live cultures found in dairy products and fermented food

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14
Q

Give examples of Upper GI symptoms

A

acid reflux, nausea, vomiting, belching, gastroparesis and bloating

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15
Q

Give examples of lower GI symptoms

A

bloating, constipation, diarrhoea, abdominal pain

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16
Q

Describe Gastroesophageal Reflux Disease (GERD) and its common causes

A

Occurs when the lower esophageal spincter is weak or relaxed abnormally

Causes- weight gain- stress

17
Q

What are the symptoms and treatment options for Gastroesophageal Reflux Disease (GERD)?

A

Symptoms- ulcer formation, inflammation and Barratt’s esophagus

Treatment: antacids + alginates (gaviscon)

sever- Proton Pump Inhibitors (block stomach acid production)

18
Q

Which drug can block stomach acid production?

A

Proton Pump Inhibitors

19
Q

What is Gastroparesis? What are the symptoms?

A

Delayed gastric emptying.

Symptoms: nausea, vomiting, rapid feeling of fullness, reflux, pain and bloating

Can cause malnutrition and changes to blood sugar

20
Q

How does Diabetes cause Gastroparesis?

A

causes neuropathy of vagal endings innervating the stomach

21
Q

How is Gastroparesis diagnosed?

A

Gastric emptying study:
C13 labeled meal is ingested

Released C13 is exhaled in breath and is used as marker of food movement through stomach
Time-course compared to normal values

22
Q

What is the treatment for Gastroparesis?

A

Domperidone or erythromycin: stimulate stomach muscle contraction

Anti-emetics for nausea

Dietary changes- smaller more frequent meals

23
Q

What is Inflammatory Bowel Disease?

A

Collective term that refers to chronic inflammation of the lower GIT-

Crohn’s Disease (CD)
Ulcerative Colitis (UC)
24
Q

Describe the main features of Crohn’s Disease (CD) and symptoms

A 
can affect the whole GIT but is often localised to small bowel
Symptoms- 
Diarrhoea
Abdominal pain
Fatigue
Fever
Blood in stool
25
Q

How does Crohn’s Disease (CD) effect the bowel?

How is it diagnosed?

A 
Scaring of bowel epithelium
Bowel obstruction
Ulcers 
Fistulas (hole in bowel)
Diagnosis-
Colonosocopy
Fecal calprotectin
26
Q

Treatment of Crohn’s Disease paediatric and adult

A

Paediatric-
Enteral nutrition for 4 weeks
replaces normal diet
promotes epithelial healing

Adult-
Corticosteroids- Prednisolone

Immunosupresssants- Azathioprine & mercaptopurine

Antibodies which neutralise TNF

27
Q

Describe the main features of Ulcerative Colitis (CD) and symptoms

A

Chronic inflammatory restricted to the colon

Symptoms 
Bloody diarrhoea
Urgency
Abdominal pain
Fatigue
Fever
Weight loss
28
Q

How does Ulcerative Colitis (CD) effect the bowel?

How is it diagnosed?

A

ulcer-like appearance of mucosa
Perforation of the colon (can be fatal)
Severe bleeding
Colon cancer

Diagnosis: Colonscopy
Fecal calprotectin

29
Q

Treatment of Ulcerative Colitis mild and sever

A

Mild- Corticosteroids - Prednisolone
5-ASAs

Sever- antibodies that neutralise TNF
Ciclosporin – IV
Surgery (colectomy)

30
Q

Symptoms of Irritable Bowel Syndrome?

A

Upper GI- functional GERD, functional dyspepsia, bloating, pain
Lower GI- abdominal pain, cramping, constipation and diarrohea.

31
Q

How is Irritable Bowel Syndrome diagnosed?

A

ROME IV questionnaire after excluding all biolgical causes

32
Q

List some possible causes of Irritable Bowel Syndrome?

A 
gastroenteritis?
Leaky gut epithelium?
Increased sensitivity to pain?
Changes to gut microbiota 
Enteric neuron abnormalities causes issues with gut motility
33
Q

What are the treatments for IBS?

A 
Dietary control e.g. FODMAP diet
Treat sysmptoms (laxatives, pain medication)

Linaclotide: increase fluid secretion and pain relief
Lubiprostone: increase fluid secretion
Rifaximin: antibiotic to treat bacterial overgrowth

34
Q

What can be found in gastric juices?

A

HCl, Salts, Pepsin, Mucus , water, intrinsic factor (critical for B12 absorption), bicarbonate (maintains pH7 at gastric epithelium with mucosal gel).

35
Q

How many neurones are in the enteric nervous system?

A

400-600

36
Q

What are bezoars? What condition causes them?

A

Hardened mass of undigested food

Gastroparesis

Metabolism (9 decks)

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