overview of gastroenterology (mini learning) Flashcards
Roughly what % of primary care consultations are about GI disorders?
10%
Are GI disorders most commonly major or minor issues ?
minor issues but with big impacts on quality of life
What are some common symptoms that present in a GI clinic ?
- indigestion
- heart burn/reflux
- dysphasia
- vomiting/nausea
- abdominal pain
- altered bowel habits (constipation/diarrhoea)
- rectal bleeding
- weight loss
- abnormal lover function tests
Give 2 examples of inflammatory bowel diseases…
Crohn’s
Colitis
How does Inflammatory bowel disease differ from Irritable bowel syndrome ?
iflammatory bowel disease = bowel is inflamed and diseased
Irritable dowel syndrome = bowel isn’t functioning properly but appears structurally normal
What classes as ‘abnormal bowel habits’ ?
- diarrhoea (increased frequency and looseness of stool)
- constipation (decreased frequency and straining to release stool)
- alternating between the 2 above (seen in IBS)
its a change from the person’s normal
What is the scale called that’s used to describe stool types ?
The Bristol Stool Form Scale
What are classed as red flag GI symptoms that should be referred to specialists ?
- weight loss
- bleeding
What are some common symptoms seen in liver disease ?
- abnormal bloods
- jaundice (seen in the sclera of the eye)
- fatigue
- abdominal swelling
What are some common symptoms seen in pancreatic disease ?
- pain
- diarrhoea (malabsorption of fat)
- weight loss
What are the 6 least survivable cancers ? Why are they so ?
- lung cancer
- brain cancer
- liver cancer
- stomach cancer
- pancreatic cancer
- oesophageal cancer
diagnoses are often quite late so prognosis is bad
What are the 2 roles of the gut?
- digestion/absorption = get food and water in
- barrier function = keep bacteria and toxins out
What are some factors that impact the brain-gut axis ?
- stress
- diet
- microbiome (infection, antibiotics)
- genome
What are the main investigations done to test for GI diseases ?
- bloods
- endoscopy
- biopsy (if abnormality found)
- imaging (ultrasound, CT, MRI, Nuclear medicine)
What findings are classed as GI emergencies ?
- GI bleeding
- severe inflammatory bowel disease (Crohn’s, colitis)
- perforation
- obstruction
- acute pancreatitis
- appendicitis
What does the ‘PEG’ stand for in ‘PEG feeding tube’ ?
Percutaneous Endoscopic Gastronomy
What is a PEG feeding tube?
A feeding tube that is inserted through the skin, directly into the stomach wall
When would a PEG feeding tube be indicated ?
When a person can no longer eat or swallow so are not getting the nutrients they need
e.g after
- stroke
- head/neck cancer
What is the purpose of a PEG feeding tube ?
To provide a person with nutrients when they can no longer eat/swallow
What is a complication of PEG tubes ?
They can sometimes get engulfed by the body as it grows around/over it = buried bumper syndrome
How are PEG tube patients supposed to help decrease their risk of getting ‘buried bumper syndrome’ ?
rotate their PEG tube every day to keep it free
What type of feeding tube is used if a patient isn’t responding well/vomiting when using a PEG tube ?
**PEG-J tube **
(extends into small intestine to avoid the stomach and, therefore, reflux)
How common is Diverticular disease ?
By the time they’re 80/90 almost everyone has it to some degree
What is diverticular disease ?
Small pockets (diverticulae) develop in the lining of large intestine, forming holes that food can get stuck in
- these get inflamed (diverticulitis)
How long does it take for a pre-cancerous bowel polyp/adenoma to turn into bowel cancer ?
~ 10 years
What are some complications of polypectomy ?
- bleeding (can be fatal)
- perforation of bowel wall (if caught in the snare used to remove the polyp - can be fatal or require surgery)
What piece of technology is used to view inside the lower gut that cannot be reached via endoscope ?
Pill-cam
a small dual-ended camera encased in a small plastic pill that records its journey through the GI tract
Are PEG tubes used as a short or long term solution ?
long term
What is TPN ?
(hint: nutrition)
Total Parenteral Nutrition
= IV nutrition