Intestine Conditions

Question 1

What is Intestinal failure?

Answer 1

It is when the intestines are unable to supply the nutritional and fluid needs to the body.

Question 2

Describe type 1 intestinal failure?

Answer 2

It is self-limiting and short term.

Patient may be moderately malnourished so replace fluids, nutrition etc…

Question 3

Describe type 2 intestinal failure?

Answer 3

It is more prolonged than type 2 and associated with Sepsis or Abdominal surgery.
To treat, probably weeks/months in the ICU with parenteral feeding (using the vein) +- enteral feeding (using the GI tract).

Question 4

Describe type 3 intestinal failure?

Answer 4

It is chronic intestinal failure.

Usually home parenteral nutrition is involved.

Question 5

Describe small bowel syndrome?

Answer 5

It is when the small bowl is <200cm, when it should be between 250 and 850cm.
It means that the small bowel isn’t long enough to support nutritional needs.

Question 6

What is the difference between a diverticulosis and a diverticulitis?

Answer 6

Diverticulosis indicates the prescense of a diverticula (mucosal hernia through the muscle), diverticulitis indicates that the diverticula are inflammed.

Question 7

Where dose diverticulitis tend to occur?

Answer 7

In the sigmoid colon.

Question 8

In most cases diverticula disease is asymptomatic and is discovered during a colonoscopy and would be treated by advice of extra fibre, however is a small amout of cases it becomes symptomatic, what would those symptoms be?

Answer 8

Intermittent left Iliac Fossa pain and an erratic bowel habit. (Makes it hard to differentiate from IBS).

Question 9

What causes diverticulitis?

Answer 9

Faeces obstruct the neck of the diverticulum causing stagnation (hence why low fibre is usually a cause and increasing fibre can lead to it being treated) allowing bacteria to settle and cause inflammation.

Question 10

What are complications of diverticula disease?

Answer 10

Pericolic Abscess.
Haemorrhage.
Fistula. 
Stricture.
Perforation.

Question 11

How do you treat uncomplicated diverticulitis?

Answer 11

You recommend a fibre diet.

You may give an oral antibiotic but probably not.

Question 12

How would you treat complex diverticulitis?

Answer 12

Percutaneous drainage.

Hartmann’s procedure.

Question 13

What causes chronic colitis?

Answer 13

Infective colitis.
UC.
Crohn’s colitis.
Ischaemic colitis.

Question 14

What are the symptoms of chronic colitis?

Answer 14

Diarrhoea +- blood.
Abdominal cramps.
Dehydration.
Sepsis.

Question 15

What is colonic angiodysplaisia?

Answer 15

It is an obscure cause of bleeding, it gives you submucosal lakes of bleeding, usually right sided colon.