Lower GI disorders AB

Question 1

What are the two classic clinical features of villous adenoma?

Answer 1

Diarrhoea with mucous
Hypokalaemia

Also microcytic anaemia

Question 2

What is the main risk factor for lower GI bleeding?

Answer 2

Age - especially 7th and 8th decade

Question 3

What is the commonest cause of lower GI bleeding?

Answer 3

Diverticulae - usually occuring at the site of the vasa recta in the left colon

Followed by internal haemorrhoids - 2nd most common

Question 4

What pathology can cause small bowel bleeding?

Answer 4

Angioectasia
Peutz-Jeghers syndrome
Meckel diverticulum
Haemangioma
Malignancy
Hereditary haemorrhagic telangiectasia

Question 5

Which investigation has the best sensitivity for active bleeding not picked up on endo/colonoscopy?

Answer 5

Technetium-labelled nuclear scan

Requires bleeding rate of 0.1-0.5ml/min