Psychiatry and GI

Question 1

Psychological factors associated with GI disorders?

Answer 1

• Current burdensome life events
• Abnormal relationships with parents
• History/present abuse
• Anxiety
• Depression
• Neuroticism
• Inadequate social support
• Difficulties in interpersonal relationships

Question 2

What is globus?

Answer 2

Sensation of having persistent or intermittent lump in throat
Diagnosis of exclusion

Question 3

Management of globus?

Answer 3

Reassurance, anti-reflux
Stop smoking
Refer to speech and language therapist
Stress treatment

Question 4

What is functional dysplasia?

Answer 4

Sensation of food sticking in oesophagus

Question 5

Management of functional dysplasia?

Answer 5

Reassurance
Dietary adjustments to avoid triggering foods
Careful chewing
Avoid fizzy drinks

Question 6

Management of psychotic symptoms?

Answer 6

Treat organic causes
Consider psychiatric admission
Antidepressants/anti-psychotics

Question 7

What is anorexia nervosa?

Answer 7

Significant weight loss
BMI<17.5 kg/m2
Intrusive thoughts of obesity

Question 8

Physical manifestations of anorexia nervosa?

Answer 8

-Decreased Na, K, Mg, PO4, Insulin, Glucose, thyroid, CV. arrhythmias 
Bone health 
Amenorrhoea 
Loss of sexual interest 
Elevated GH, Cortisol, cholesterol

Question 9

Bulimia nervosa?

Answer 9

Similar to anorexia nervosa, although no endocrine abnormalities.

Question 10

Management of bulimia nervosa?

Answer 10

Establish therapeutic alliance

Focus on strategies to deal with stress