Pro/pre/synbiotics, Dysphagia, Regurgitation Flashcards
What are intestinal microbiota? What is the intestinal microbiome?
Microbiota: bacteria, viruses, fungi, archaea, protozoa (> 10x cells in body)
Microbiome: mutual interaction of the microbiota with the host cells
What are the methods of microbial characterization?
Bacterial culture
Molecular techniques: DNA/RNA extraction, PCR, amplicons, quantification
Metagenomics, transcriptomics
What mechanisms control the population of bacteria in GI tract?
Gastric acid, bile: uninhabitable conditions for most bacteria
Intestinal motility: wash bacteria downstream, prevent proliferation
Intestinal mucus: barrier, prevent bacteria from attaching to epithelium
Immune responses
Bacteria (bacteriocins, colonization resistance)
What is the difference between prebiotics, probiotics, and symbiotics?
Prebiotics: non-digestible dietary carbs, promotes growth of “good” bacteria, increased short-chain fatty acids (ex. Fructooligosaccharides, bran, psyllium)
Probiotics: living microorganisms that improve epithelial barrier, immune system, and inhibit pathogen colonization. Different strains/combinations affect effectiveness
Symbiotics: combination of pre and probiotics
What are the pros/cons of bacterial culture?
Pros: good to test viability, susceptibility, genotypic analysis, metabolism, virulence
Cons: unknown optimal growth requirements, anaerobic culture needed, synergism for growth
What do metagenomics and transcriptomics tell you about gut bacteria?
Very different groups of gut bacteria in different people still fulfill same purpose/function by producing same products
How does disease location in dysphagia affect clinical signs?
Pharyngeal/upper esophageal disease: dysphagia
Esophageal body: regurgitation and ptyalism
Distal esophagus: inappetence and ptyalism
Cricopharyngeal (neuromuscular disease- clinical signs start around weaning, more trouble with liquids than solids)
What are the four basic causes of regurgitation and what are examples of each?
Inflammatory disease (esophagitis, myositis, granuloma)
Extra-luminal obstruction (vascular ring anomaly, thymoma)
Intra-luminal obstruction (stricture, foreign body, tumor)
Neuromuscular disease (Dysmotility, megaesophagus)
What is the difference between primary and secondary peristaltic waves? What initiates them?
Primary: stimulated by nerve impulse, pushes food bollus to stomach
If the esophagus is not entirely cleared, the stretch of esophagus will stimulate secondary peristalsis
What are the causes of esophagitis?
Ingestion of caustic material
Foreign body
Drugs
Reflux of gastric acid
How do you diagnose esophagitis?
Survey radiographs
Contrast radiographs
Endoscopy
How do you manage esophagitis?
Sucralfate Increase LES tone (cisapride) Reduce acid output (omeprazole) Pain meds Rest esophagus (PEG tube)
