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IFM GI > IBD and diverticulitis > Flashcards

IBD and diverticulitis Flashcards

1
Q

what inhibits beta glucuronidase?

A

calcium glucarate

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2
Q

Th2 mnemonic

A

Ah-choo! Two! (antibodies, allergies)

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3
Q

diet triggers for IBD

A

diet (high fat & sugar, processed foods),

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4
Q

IBD and SDH

A

42% of IBS had at least one SDH

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5
Q

lifestyle factors to reduce risk of IBD?

A 
Physical activity
Breastfeeding
Bed sharing
Tea consumption
 High levels of folate
High levels of vitamin D
 H pylori infection
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6
Q

early life factors and CD

A

lower with BF

higher with maternal smoking in utero

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7
Q

Diet to decrease IBD risk

A

Fiber
Fruit
Vegetables
High n-3 FA

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8
Q

Diet factors that increase IBD risk

A 
Animal Protein
Heme iron, Sulfur
Refined sugars
High-fat (trans)
emulsifiers
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9
Q

Diet, Microbiome and IBD

A

animal fat, milk fat, iron, emulsifiers - IBD flares
high sugar - leads to IP, AIEC
high fat diet - dysbiosis, ileitis
maltodextrin - AIEC and biofilms
iron, red meat - mitigated by resistant starches

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10
Q

low FODMAP diet and IBD

A

helps with Sx

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11
Q

eating rainbow and IBD

A

flavones and resveratrol decreased IBD

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12
Q

best alcohol for microbiome diversity

A

red wine

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13
Q

How do probiotics help with IBD

A

Inhibit Pathogenic Bacteria
Improve Epithelial Function
Immunoregulation

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14
Q

should you use prebiotics in CD?

A

No but yes for UC

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15
Q

“Reinoculate” for IBD

A

Probiotics
•Prebiotics
•Short chain fatty acids

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16
Q

“Repair” strategies for IBD

A
  • Omega 3 Fatty Acids
  • Immunoglobulin/protein
  • Boswellia
  • Vitamin D
  • Curcuminoids
  • L-Glutamine
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17
Q

L-glutamine doses

A

2 - 4 g/d in divided dosages for wound healing and
general intestinal support
• 10 - 30 g/d in divided dosages for critically ill and
advanced disease

18
Q

other botanicals for IBD

A 
Bioflavonoids: 
quercetin
rutin
wheatgrass
ginger
turmeric
green tea
boswellia
19
Q

Nutraceuticals for IBD

A 
Whey protein with concentrated immunoglobulins:
• Serum Bovine-derived immunoglobulins
• Glutamine
• Larch (Arabinogalactans): 
butyrate
20
Q

Artemisia absinthium (worm wood)

A

Induction of remission mild to

moderate disease in CD

21
Q

Nutraceuticals for IBD

A 
whey protein with concentrated Igs
Serum Bovine-derived immunoglobulins
Glutamine
Larch (Arabinogalactans)
vit D
butyrate
22
Q

alternative Tx for IBD

A

helminths

LDN

23
Q

“Rebalance” for IBD

A
  • Mindfulness-Based Interventions
  • Stress Management
  • Hypnotherapy
  • Relaxation Training
  • Acupuncture
24
Q

Risk factors for diverticular disease

A

Age • DD in patients younger than 50 years is a more virulent disease and is more
predominant in men
• Incidence increases steeply with age, beginning at age 40 years
Diet DD is associated with a history of low-fiber diet
Gender Incidence is more predominant in men before 65 years of age, and more
predominant in women after 65 years of age
Geography • Most common in industrialized nations
• Less common in Asian countries, where it tends to be right-sided
Medication use • Chronic NSAID use doubles the risk for DD and quadruples risk of perforation
• Opioids and corticosteroids increase risk of perforation
• Calcium channel blockers reduce risk of perforation
Obesity Striking increase in incidence among the obese, especially before age 40 years
Physical activity Risk of developing DD is inversely proportionate to activity level
Smoking Contradictory findings

25
Q

protective factors for diverticulitis

A 
BMI 18-25
• Red meat <4/week
• ≥ 23 g fiber/day
• Exercise 2 hrs/week
• No smoking
26
Q

diverticulitis Tx - with abx?

A

Omitting antibiotics in the treatment of
uncomplicated acute diverticulitis did not
result in more complicated diverticulitis,
recurrent diverticulitis or sigmoid
resections at long-term follow up.

27
Q

diverticulitis Diet

A

This systematic review and GRADE assessment conditionally
recommend the use of liberalized diets as opposed to dietary
restrictions for adults with acute, uncomplicated diverticulitis.
• It also strongly recommends a high dietary fiber diet aligning
with dietary guidelines, with or without dietary fiber
supplementation, after the acute episode has resolved

28
Q

diverticulitis Tx

A

fiber
probiotics
rifaximin

Kefir and exercise, stress reduction

29
Q

DD and age

A

increased!
DD in patients younger than 50 years is a more virulent disease and is more predominant in men
• Incidence increases steeply with age, beginning at age 40 years

Gender Incidence is more predominant in men before 65 years of age, and more
predominant in women after 65 years of age
Geography • Most common in industrialized nations
• Less common in Asian countries, where it tends to be right-sided
Medication use • Chronic NSAID use doubles the risk for DD and quadruples risk of perforation
• Opioids and corticosteroids increase risk of perforation
• Calcium channel blockers reduce risk of perforation
Obesity Striking increase in incidence among the obese, especially before age 40 years
Physical activity Risk of developing DD is inversely proportionate to activity level
Smoking Contradictory findings

30
Q

DD and diet

A

associated with a history of low-fiber diet

31
Q

DD and age

A

increased!
DD in patients younger than 50 years is a more virulent disease and is more predominant in men
• Incidence increases steeply with age, beginning at age 40 years

32
Q

DD and geography

A

Most common in industrialized nations

• Less common in Asian countries, where it tends to be right-sided

33
Q

DD and meds

A

Chronic NSAID use doubles the risk for DD and quadruples risk of perforation
• Opioids and corticosteroids increase risk of perforation
• Calcium channel blockers reduce risk of perforation

34
Q

DD and obesity

A

Striking increase in incidence among the obese, especially before age 40 years

35
Q

DD and physical activity

A

Physical activity Risk of developing DD is inversely proportionate to activity level

36
Q

DD and smoking

A

Smoking Contradictory findings

37
Q

meds that increase IBD

A

ocp NSAIDs

38
Q

appy and tonsillectomy adn IBD

A

increase

39
Q

vit deficiency that can cause IBD

A

D

40
Q

IBD higher in urban or rural?

A

urban

41
Q

does H pylori infection increase or decrease IBD

A

decrease

42
Q

does smoking increase or decrease IBD

A

increase

IFM GI (8 decks)

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