Lower Gi Flashcards
simple vs strangulation obstruction
simple - ingested contents accumulation causing distention of proximal bowel with NO vascular compromise
strangulation - vascular compromise, leads to infarction and gangrene
small vs large bowel obstruction symptoms
small - quick onset
large - mild, gradual
diagnosis for bowel obstruction + chiroman
xrays
laparotomy - for strangulation
barium/edema swallow
refer out
where is diverticulosis most common and which country has prevalence
sigmoid colon - western
presentation for diver
MC in what age
+ symptoms
over 40
left lower abdo pain (sigmoid)
fever
rectal bleeding
diagnosis for diver + chiroman
KUB (Pneumoperitoneum if perforation)
CT
colonoscopy
barium enema
referral for active diver
adjust to tolerance
how is appendicitis caused
inflammation, fecaliths, foreign body, seeds
symptoms for appendicitis
poor localised pain then localizes to RLQ over 2-12 hrs
constant pain worse with coughing
sudden relief - rupture
abdo exam for appendicitis
RLQ pain upon palpation
rebound tender
psoas
obturator
mcburney point
vitals for appendicitis
low fever
high fever - perforation
which part of the bowel is Chrons is MC in
distal iluem spares rectum
chrons symptoms
chronic diarrhea w abdo pain
fever
weight loss
anemia
rebound tender if flare up
how to diagnose chrons and what will you see in labs
colonoscopy + biopsy
barium contrast
anemia
hypoalbumenia
ESR + CRP
what is UC and which part is MC
inflammation of the mucosa and submucosa and rectum
UC symptoms
insidious increase urgency to poop
bloody diarrhea
lower abdo cramps
asymptomic between periods of attack
diet requirements for UC
avoid raw fruits & veges
↓ meat + alcohol
increase Omega 3
avoid NSAIDS
diagnosis for UC
sigmoidoscopy + biopsy
3 types of IBS
A - diarrhea + constipation
C - constipation predominant
D - diarrhea predominant
when does IBS begin and what symptoms should they have for 3-6 months
early 20s
pain relieved by defecation
patient will swap between constipation and diarrhea
abdo cramps
lactose intolerance MC in what ethnicity
80% black, hispanics and 100 in asians
incidence of bowel cancer rises from what age
age 40 peaks at 60-65
95% adenocarcinoma
what will you see in labs for bowel cancer
CEA ↑
fecal test
diagnosis for bowel cancer
what will you do for early detection
barium/colonscopy
colonscopy every 3 yrs after 40 for early detection