Malabsorption Flashcards
Anatomy of small intestine
duodenum
jejunum
ileum
What initiates digestion of protein in the stomach?
pepsin
Why is fibre not digested?
(mostly cellulose)
highly resistant to hydrolases
What is the main job of the gut?
absorption of nutrients
How are nutrients absorbed in the gut?
villi
villi also have microvilli
high SA for absorption
What are proteins digested down into?
tripeptides
dipeptides
amino acids
Where are bile salts reabsorbed?
terminal ileum
Name some conditions that can affect the GI tract’s ability to absorb?
coeliac
crohn’s
radiation enteritis
surgical disasters
tumours - neuroendocrine, FAP, desmoid disease, EATL
vascular problems
NSAIDs
infections
internal volvulus
gastric bypass surgery
severe pancreatitis
paediatric:
- intestinal atresia
- gastroschisis
- midgut volvulus
- aganglionosis
- tumours
Name and describe the types of intestinal failure
type 1 = self-limiting, post op ileus, acute inflammation, <28 days
type 2 = prolonged, GI complications, EC fistula, abdominal sepsis, >28 days, metabolically unstable
type 3 = short bowel syndrome, chronic obstruction, motility disorder, ?TPN, usually irreversible, metabolically stable
5 major conditions causing intestinal failure
short bowel
intestinal fistula
intestinal dysmotility
mechanical obstruction
extensive small bowel mucosal disease
What is classed as short bowel syndrome?
<2m of small bowel
Short bowel syndrome management
St Marks solution
double strength diarolyte
loperamide
codeine
lanreotide
SC fluids/electrolytes
IV fluid/electrolytes (central line)
TPN
Intestinal failure operations
reversal of stomas
putting bowel back into continuity
repair of fistulas
stricturoplasty
removal of obstruction
