lower digestive system disorders Flashcards
infective disorders: ???% of cases of enteritis are due to infection with
pathogens from food or drink
90%
other causes of enteritis (outside food/drink) include all BUT which option?
- NSAIDs
- Radiation therapy
- IBD
- Coeliac Disease
- chemo
- chemo
pathogens causing enteritis include:
Bacterial:
Salmonella
Clostridium difficile
Campylobacter jejuni
as well as what virus?
Rotavirus
TRUE or FALSE:
Bacterial infections have more severe effects than viral infections
TRUE
clinical manifestation of enteritis caused by rotavirus:
- alters function of ??? cells, causing malabsorption
alters function of epithelial cells causing malabsorption of food
watery diarrhoea (caused by CHO, fat and protein are osmotically active = leads inability to absorb water) is a clinical manifestation of enteritis caused by which pathogen?
rotavirus
fever, vomiting, dehydration are common manifestations of which pathogen causing enteritis?
rotavirus
groups most at risk of catching rotavirus = ???
babies and toddlers
TRUR of FALSE:
Clostridium Difficile: Naturally occurring gut bacteria in humans. Becomes pathogenic when there is a disruption to the number of good gut bacteria that normally suppress growth of C. Diff
TRUE
toxins of clostridium difficile bind to epithelial cells (haemorrhage), attract ??? cells, increase capillary permeability, stimulate peristalsis = Fever, Abdominal pain, Diarrhoea
inflammatory
Campylobacter Jenjuni cause enteritis by penetrating mucus
layer and attaching to ??? cells and releases toxins
epithelial cells
which pathogen is the most prevalent food borne cause of enteritis?
campylobacter jenjuni
abdominal pain, fever, diarrhoea, are common signs of which enteritis causing pathogens?
Hint: there are 2
campylobacter jenjuni and clostridium difficile
treatment of enteritis-causing pathogen includes: good hand hygiene, good food handling, hygiene in general and in the case of ??? and ??? bacteria, antibiotics
C Diff and C. jejuni: Antibiotics
IBD (irritable bowel disease) is an umbrella term for which two gut-related issues?
crohn’s disease
ulcerative colitis
TRUE or FALSE: Crohn’s disease is characterised by inflammation of the lining of the entire digestive tract and often disrupts all four layers
TRUE
Ulcerative colitis causes long-lasting
inflammation and ulcers in the ??? layer of the large intestine.
mucosal layer
TRUE or FALSE: crohn’s disease and ulcerative colitis don’t both have periods or remission and relapse
FALSE. they do both have them
Features of Chron’s disease DON’T include which one?
- Can be full thickness ulceration
- Skip regions
- Thickened wall, narrow lumen
- Fistulae
- only affects upper GI
- only affects upper GI is INCORRECT, it affects all parts of GI
What are skip lesions in Chron’s disease? THINK progression of lesions
Chron’s disease is NOT progressive and can affect multiple, separate parts of the GI tract at once
Ulcerative colitis does or does not contain skip lesions? explain
ulcerative colitis does NOT contain skip lesions, it has a progressive movement along colon that beginning at the rectum
clinical manifestations of Chron’s disease in the Small Intestine:
??? of nutrients
malabsorption of nutrients
clinical manifestation of Chron’s disease in colon:
malabsorption of ???
malabsorption of water
Can there be clinical manifestations of Chron’s disease in the oral cavity?
yes
common clinical manifestations of Crohn’s disease:
pain
LOW,
malena (black blood from bleeding is visible),
???,
???,
low appetite
diarrhoea
fever
nutritional implications of Crohn’s disease:
Malabsorption of nutrients
- Fe, folate, B12 = nutritional ???
anemias
Malabsorption of nutrients in Crohn’s disease:
- Mg, Zn: ???
wound healing
Malabsorption of nutrients in Crohn’s disease:
- Vit D and Ca: ???
bone health
Malabsorption of nutrients in Chron’s disease:
- Vit K: ???
clotting
Malabsorption of nutrients in Chron’s disease:
- Fat: ??? – LOW
steatorrhoea
treatment for Crohn’s disease:
nothing. Can control it through:
- Medication–> Immunosuppression: can be life long.
- Some evidence high dose ??? fat can be helpful.
- Antibiotics for infection eg abscess
- Elemental tube feeds
- Surgery: can resect regions and rejoin
omega 3
Ulcerative colitis features:
Chronic inflammation of mucosal and submuscosal layer of ??? that IS or ISN’t progressive?
colon
it IS progressive
Ulcerative colitis is characterised by frequent bloody mucousy ???
(> 30 x day)
diarrhoea
clinical manifestations of Ulcerative Colitis:
- Loss of mucin layer. Lesions form in crypts of Lieberkühn in base of ??? layer
- Diarrhoea, Abdo pain, Malena, LOW
mucosal
TRUE or FALSE: long term complications of ulcerative colitis is that it can lead to bowel cancer due to acute bowel obstruction and toxic megacolon.
TRUE
Treatment of ulcerative colitis:
No treatment, but can have medication: immunosuppression which can be life long. ALSO ??? can resect whole colon
surgery
what type of inflammation does Crohn’s disease have in comparison to ulcerative colitis?
granulatomous orulcerative/exudative
granulatomous
are fistulas common in Crohn’s disease or ulcerative colitis?
crohn’s disease
diverticular disease is a pathological condition: presence of several sacs/pouches formed by ??? of the intestine wall
herniation
TRUE or FALSE:
Diverticulitis: inflammation of one or more of the diverticula, especially the colon
TRUE
TRUE or FALSE: Diverticulitis is not very common in western world
FALSE it is rare in developing countries
reasons for diverticulitis developing include:
- Age = weakening of colon wall
- Obesity.
- ???
- Lack of exercise.
- Diet high in animal fat and low in fiber (constipation)
- NSAIDs, steroids
Smoking.
clinical manifestations of Diverticulitis:
- 80% suffer no adverse effects
- Hypertrophy in the sigmoid colon =
narrowing of ??? = bowel blockage
lumen
TRUE or FALSE: ~25% of diverticulitis develop infection of pouch – perforation and abscess =
pain, bleeding, pus, diarrhoea . 1 In 3 need surgery
TRUE
treatment of diverticulitis includes:
- antibiotics, bowel rest, IV fluids for acute cases
- Diet progression: NBM /clear fluids/ ??? or ??? diet
low fibre / normal diet
prevention of diverticulitis includes a ??? diet, exercise, correct technique to poo (which is 35 degree angle)
high fibre
IBS is a functional bowel disorder involving:
- ??? contractions (motility)
- increased gut sensations (visceral hypersensitivity)
- Relief from symptoms after defecation
abnormal gut contractions
IBS is present in ??? of the population
15%
cause of IBS is KNOWN or UNKNOWN and related to multiple factors including motility,
inflammatory, genetic, immune, psychological, and dietary components
unknown
IBS has no structural abnormalities, but it is a real ??? problem due to altered colonic motility and hormones. ALSO associated with ???, stress and lifestyle
physiological.
menstruation
common clinical manifestations fo the 3 types of IBS (classified by stool):
pain, ???, flatulence, nausea, anorexia, anxiety or depression.
bloating
treatment of IBS includes lifestyle management to reduce ???, avoid
gastric stimulants eg caffeine, alcohol, and personal triggers
stress
TRUE or FALSE: Constipation is the most common function GI disorder and causes major morbidity
True
primary causes of constipation do NOT include which one:
- Slow transit time eg IBS-C, neuropathy
- Inadequate fibre and
fluid intake
- Cancer eg bowel or
obstruction or stricture
Cancer eg bowel or
obstruction or stricture– this is a secondary cause
secondary causes of constipation do NOT include which one:
- Metabolic: eg hypothyroid
- Neurological – MS, Parkinson’s disease, SCI
- Medication: eg opioids, Fe,
antihistamines
- Cancer eg bowel or obstruction or stricture
- inadequate fibre and fluid intake
- inadequate fibre and fluid intake – primary cause, NOT secondary
nutritional implications of constipation:
can impact absorbance/intake of ???
nutrients
constipation treatment includes:
??? and fluid +/ - regular aperients
fibre
coeliac disease is a short or long term autoimmune disorder characterised by damage to the small intestine from ingestion of gluten
long term
TRUE or FALSE: coeliac disease is present 1 in 70 (1% =1:86 men; 1 :52 Australians women)
TRUE
clinical manifestations of coeliac disease:
- Allergy to gluten = inflammation gastritis and atrophy of JEJUNAL, ILEUM, or DUODENAL mucosa in SI (Loss of mature villous epithelium)
JEJUNAL
clinical manifestations of coeliac disease:
- Flat jejunal mucosa (ie villi absent) =
reduced OR increased enzyme activity for digestion
reduced
signs of coeliac disease:
???, Steatorrhea, Abdo pain, lethargy, anaemia,
Diarrhoea
steatorrhea is ??? = undigested fat in faeces, stinky stool, and rapid LOW
Malabsorption of fat
nutritional consequences of coeliac diseasE:
Lack of minerals
- Fe, folate and B12 = nutritional anaemias
- Ca: ???
osteoporosis
nutritional consequences of coeliac disease:
Lack of vitamins:
- Vit B, C
- Vit K: ???
blood clotting
TRUE or FALSE: Ca not absorbed in coeliac disease can lead to development of oxalate kidney stones
TRUE
treatment of coeliac disease includes lifelong avoidance of gluten. Atrophied intestinal villi can take ???years to heal
3.8 years
