mix of GI diseases Flashcards
what can H. pylori infection cause?
- inflammation
- peptic ulcer
- gastric cancer
How can H.pylori be detected?
- serological tests
- C urea breath test
- Stool antigen test
what is used to predict if a patient has appendicitis?
Alvarado score, calculated using MANTRELS (out of 10) <5=unlikely 5-6= possible 7-8= likely 8-9= very likely
Migration to RIF (1) Anorexia (1) Nausea and vomiting (1) Tenderness in RIF (2) Rebound pain (1) Elevated temp (1) Leucocytes (1) Shift of white blood cell count to the left (1)
what is acute appendicitis?
inflammation of the appendix
what causes appendicitis?
- most of time unknown
- fecaliths
- viral/bacterial infection
- parasites
- lymphoid hyperplasia
- tumours
presentation of appendicitis?
MANTRELS
Pain in middle of abdomen that may come or go, within hours pain travels to lower right hand side and becomes constant and severe, pain may get worse when pressing the area/walking/ coughing
investigations for acute appendicitis?
- clinical diagnosis
- USS
- bloods (neutrophil and leucocytes and elevated CRP)
- CT may be useful if unclear
management of appendicitis?
- analgesia (pain relief) and antipyretic (reduces fever)
- ABs (piperacillin/ Tazobactam)
Appendectomy ideally laparascopically
what is cause of achalasia?
damage to myenteric plexus of oesophagus
what is achalasia?
esophageal aperistalisis and impaired relaxation of LOS
investigations of achalasia?
- Ba swallow
- CXR
- endoscopy (endoscope will pass easily through LOS)
- manometry (pressure check)
treatment of achalasia?
- CCB
- nitrates
- antacids
- balloon stent
what is dyspepsia?
indigestion
ALARM symptoms- dyspepsia
- vomiting
- dysphagia
- weight loss
- anorexia
- haematemesis or malaena
where is gastric cancer derived from?
mucose secreting cells
types of gastric cancer?
intestinal (type 1) cancer and diffuse (type 2) cancer
difference between intestinal and diffuse gastric cancer?
intestinal
- arises from areas of intestinal metaplasia
- strong association with H.pylori
- most likely to involve distal stomach
Diffuse
- arises from areas of normal gastric mucosa
- occurs in younger population
- similar frequency through out the body
symptoms of gastric cancer?
early- usually asymptomatic
Advanced
- weight loss
- ulcer like pain
- anorexia
- nausea
- early satiety
- upper GI bleeding
- dyspepsia
- anaemia
signs of gastric adenocarcinoma?
anaemia and palpable epigastric mass
investigations of gastric adenocarcinoma?
- endoscopy with biopsies
- CT for staging
- laparoscopy to determine if patient is suitable for surgery to exclude serosal disease
treatment for adenocarcinoma?
surgery
palliative care
most common cause of upper GI bleed?
peptic ulcers
what do patients with chronic GI bleeding usually present with?
anaemia
definition of diarrhoea
-more than three lose stools in 24 hours
what is IBS?
bowel disorder characterised by recurrent abdominal pain and abnormal defecation in the absence of a structural abnormality of the gut
How is IBS diagnosed?
-clinical diagnosis
there should be at least one day per week in 3 months that recurrent abdominal pain is associated with two or more of :
- related to defecation
- onset associated with a change in frequency of stool
- onset associated with change in appearance of stool
Management of IBS-D?
1.Positive diagnosis and reassurance 2. Diet: avoid sorbital, sweeteners, caffeine and alcohol, reduce fibre intake, trial low FODMAP/gluten free 3. Antidiarrheal drugs: loperamide, codeine phosphate, cholestyramine 4. Anti depressants (low dose): amitriptyline 5. Antibiotic: rifamixin
what is hemangioma?
the most common benign liver tumour world wide
who is hemangioma more common in?
females> males
