Psychiatry and the GI Tract

Question 1

co-morbidity of mental health and GI

Answer 1

40-50%

Question 2

globus sensation

Answer 2

sensation of a lump in the throat

CAUSES:
foreign body
reflux
inflammation of pharynx
pharyngeal pouch
cancers
pollen food syndrome / oral allergy syndrome
neurological conditions

Question 3

globus

Answer 3

diagnosis of exclusion

commonly experienced with an intense emotional experience

nervousness may lead to a dry mouth, repeated swallowing and enhanced awareness of the throat

Question 4

globus - management

Answer 4

reassurance
anti-reflux treatment
stop smoking
treatment for stress
referral to speech and language therapy

Question 5

functional dysphagia

Answer 5

sensation of solid food sticking on the way down the oesophagus

diagnosis of exclusion

Question 6

functional dysphagia - management

Answer 6

reassurance
dietary adjustment
advising careful chewing of food
avoiding fizzy drink

Question 7

dysregulation of the brain-gut axis

Answer 7

greater stress reactivity

Question 8

medically unexplained symptoms - management

Answer 8

take your patient seriously and acknowledge and validate their problems

reassure

treat the treatable

symptom management

screen for depressive illnesses

Question 9

anorexia nervosa

Answer 9

significant weight loss
BMI < 17.5 kg/m2

children fail to make expected weight gain during growth

Question 10

bulimia nervosa

Answer 10

low/normal/increased weight

no endocrine abnormalities

Question 11

AN and BN - treatment

Answer 11

establish therapeutic alliance

weight gain is essential

psychological interventions

drugs - ineffective or no impact