Lower GIT Flashcards
what are the components of the lower GIT?
small intestine - jejunum, ileum
large intestine - colon
what occurs in the small intestine?
digestion and absorption of nutrients
what is absorbed in the duodenum?
iron
what is absorbed in the jejunum? 2
iron
folate
what is absorbed in the ileum?
vitamin B12
what occurs in the large intestine? 3
absorption of water and electrolytes
faeces is formed and stored temporarily
bacteria ferment indigestible material
what is required for vitamin B12 absorption?
intrinsic factor produced by the gastroparietal cells
how does lower GIT bleeding present?
fresh blood mixed with stool - haematochezia
may not be visible - occult blood
what radiological investigations are used to look at the GIT?
Barium swallow
Barium meal
Barium enema
what is the difference between barium swallow and meal?
barium meal follows through to the small intestine
what is a barium enema?
administered by a tube inserted into rectum
for imaging of the colon
how can the small intestine be imaged visually?
endoscopy
how can the large intestine be examined?
sigmoidoscopy
colonoscopy
what is the difference between a sigmoidoscopy and colonoscopy
colonoscopy - the whole colon is explored
sigmoidoscopy - lower 1/3 of colon
name 4 lower GI disorders
coeliac disease
inflammatory bowel disease
diverticular disease
irritable bowel syndrome
what is coeliac disease?
autoimmune condition where gluten activated an abnormal mucosal response with chronic inflammation and damage to the lining of the small intestine
what is gluten found in? 3
wheat
barley
rye
what results from the inflammatory response from coeliac disease? 2
villous atrophy
crypt hyperplasia
what is villous atrophy?
villi of small intestine erode away leaving a virtually flat surface
what is crypt hyperplasia?
when the intestinal crypts are longer than normal
what factors increase the risk of developing coeliac disease? 3
genetic
autoimmune thyroid gland disease
type 1 diabetes
what are the symptoms of coeliac disease? 4
malaise - general feeling of illness/fatigue
abdominal discomfort
diarrhoea
weight loss
coeliac disease can cause malabsorption so leads to deficiencies in? 3
iron
folate
B12
how is coeliac disease managed? 3
gluten free diet
correct any deficiencies
asses osteoporosis risk
how is coeliac disease monitored?
annual review with blood tests
what is dermatitis herpetiformis?
immunobullous disease linked to coeliac disease may affect the oral mucosa
what are the most common oral manifestations of coeliac disease? 2
oral ulceration
enamel hypoplasia
patients with coeliac disease who have osteoporosis may be taking bisphosphonates, what dental affect does this have?
increase risk of developing osteonecrosis of the jaws after certain dental treatment
irritable bowel disease includes what two diseases?
Crohn’s disease
ulcerative colitis
where in the body is ulcerative colitis found?
large intestine
where in the body is Crohn’s disease found?
entire GI tract
what is inflammatory bowel disease?
chronic inflammatory diseases of unknown cause
what are the differences in inflammation between Crohn’s and ulcerative colitis?
ulcerative colitis the inflammation is continuous and mucosal
Crohn’s the inflammation is not continuous and transmural
oral features of Crohn’s disease 5
oral ulceration
mucosal tags
lip swelling
gingival inflammation
cobblestone mucosa
how is inflammatory bowel disease investigated? 3
blood test
stool sample
colonoscopy
how is Crohn’s disease managed? 3
corticosteroids
immunosuppressants
biological therapy
how is ulcerative colitis managed? 4
aminosalicylates
corticosteroids
immunosuppressants
biological therapy
how is IBD treated?
surgery (Crohn’s not curative)
parenteral nutrition (IV) - bowel resting
antibiotics for complications
what does diverticula mean?
they are pouches of the colonic mucosa which have passed through the muscular wall of the colon
what is diverticulosis?
Diverticula are present but asymptomatic
what is diverticular disease?
Symptoms, e.g. lower abdominal pain, are present
what is diverticulitis
The diverticula are inflamed and infected, the patient may feel generally unwell, feverish and suffer from acute abdominal pain
name 3 functional GI disease
irritable bowel syndrome
functional dyspepsia
functional consitpation
what is IBS
abdominal pain with altered bowel habit
how is IBS treated? 4
fibre
anti-spasmodics
amitriptyline
SSRIs
what drugs can exacerbate IBD and IBS
NSAID’s
name some symptoms associated with GIT diseases secondary to aneamia/haematinic deficiency as a result of malabsorption and blood loss 5
aphthous like ulceration
angular cheilitus (corners of mouth)
oral candidosis (thrush)
glossitis (tongue)
burning sensation in mouth
