Lower GI Inflammatory Disorders and GI Malabsorption Flashcards
What is appendicitis?
Inflammation of the appendix due to obstruction of the opening of the appendix
What are the signs and symptoms of appendicitis?
Periumbilical pain shifting to the lower right quadrant
- Guarding
- Tenderness/rebound tenderness
Anorexia
Nausea and vomiting
What tests can be used to diagnose appendicitis?
Gold standard: CT/Ultrasound
Physical examination
Increased white blood cell count
Urinalysis
What is the treatment for appendicitis?
Laparoscopic appendectomy
NO LAXATIVES
What are the complications of appendicitis?
Rupture –> Peritonitis
Abscesses
What is diverticulosis?
What is the main cause of diverticulosis?
What is diverticulitis?
Diverticulosis is the formation of multiple, non-inflamed pockets in the bowel (diverticula)
Diverticulitis is the inflammation of these diverticuli
Diverticulosis is caused by low fibre intake
What are the signs and symptoms of diverticulitis?
Acture lower left quadrant pain
Palpable masses
- Diverticula becomes swollen and can be felt on the abdominal surface
Systemic infection symptoms
Altered bowel movements
- Change in size
- Presence of mucus and/or blood
What are some diagnostic tests for diverticulitis?
CT with contrast
Blood tests
Physical exam
History
What is the treatment for diverticulitis?
General:
- High-fibre diet
- Increase activity and weight management
- Stool softeners
- Clear liquid diet
Acute:
- Rest colon
- Inflammation management
- Oral antibiotics
- NBM
- Nasogastric suction
- Surgery if abscess or obstruction
What are the complications of diverticulitis?
Diverticular bleeding
Abscess
Perforation into peritoneum
- Peritonitis if uncontained
What is peritonitis?
What are the primary and secondary causes of peritonitis?
Inflammation of the peritoneum
Primary cause: Organisms invading the abdomen (Uncommon - intact gut)
Secondary cause: Rupture/perforations/Trauma (Most common)
What are the signs and symptoms of peritonitis?
Severe abdominal pain
- Tenderness over-involved area
- Rebound tenderness
Distension
Spasm
Fever
What are some diagnostic tests for peritonitis?
Abdominal X-ray and ultrasound
Blood tests
Peritoneoscopy
Aspiration if ascites present (less common)
What is the treatment for peritonitis?
Antibiotics
Pain relief
IV Fluids
Nasogastric suction
- Remove the bowel contents so they don’t leak into the peritoneum
Surgery
- Flush antibiotics into the peritoneum and leave antibiotics in the peritoneal space (Peritoneal lavage)
What are the complications of peritonitis?
Sepsis
Hypovoloaemic shock
What are two examples of inflammatory bowel diseases?
Two examples of inflammatory bowel diseases are Chron’s disease and Ulcerative colitis
What is Chron’s disease?
What causes Chron’s disease?
A chronic inflammatory bowel disease that usually affects the ileum and the colon but can affect all parts of the GI tract
Chron’s disease is of unknown origin
What are the signs and symptoms of Chron’s disease?
Diarrhea
Weight loss
Abdominal pain
Fever
Fatigue
What is ulcerative colitis?
What causes ulcerative colitis?
Inflammation of the colon with the development of mucosal and sub-mucosal ulcers
Ulcerative colitis is of unknown origin
What are the signs and symptoms of ulcerative colitis?
Blood in stool
- Brown blood = Old
- Red/Large amount of blood = Invasion or erosion of a blood vessel into the bowel
Diarrhea
Rectal bleeding
Abdominal pain
What is the treatment for inflammatory bowel diseases?
Medication
Nutritional management/Dietary adjustments
- Ensure adequate caloric intake
Inflammation management
- Steroids
- Antibiotics if infected
Stress management
Smoking cessation
Surgery depending on the type of inflammatory bowel disease
What are the complications of inflammatory bowel diseases?
Haemorrhage
Strictures
- Tightening bands around bowels
Perforation
Dilatation
Fissures
- Crack
Fistulae
- A tract from one lumen to another
- Increased risk of rectal and intestinal cancers
How is Chron’s disease diagnosed?
Often through biopsy
What is the surgical intervention for Ulcerative colitis?
Total or partial colectomy with the formation of an ileal pouch or ileostomy (AKA proctocolectomy)
