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Alimentary System > Psychological Aspects of Gastrointestinal Disease > Flashcards

Psychological Aspects of Gastrointestinal Disease Flashcards

1
Q

What are examples of psychological aspects of GI disease?

A

Organic disease

Functional GI disease

Psychological problems presenting as GI disease

Psychological problems caused by GI disease

Assessment

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2
Q

What should be remembered about fear and GI diseases?

A

Both acute and chronic GI diseases carry huge fears

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3
Q

Are functional GI diseases more common in younger or older people?

A

Younger people

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4
Q

What parts of the gut do functional GI diseases affect?

A

Every part of the gut

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5
Q

What are examples of upper GI functional diseases?

A

Reflux

Functional dyspepsia

Nausea vomiting syndromes

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6
Q

What is an example of an intestinal GI disease?

A

IBS

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7
Q

What is an example of a biliary functional GI disease?

A

Sphincter of Oddi dysfunction

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8
Q

What are the investigations and physical examination like for functional GI diseases?

A

Normal

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9
Q

What is some of the aetiology of functional GI diseases?

A

Motility

Gut hormones

Gut microbiome

Diet

Increased visceral sensation

Psychological factors

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10
Q

What are examples of psychological problems caused by GI disease?

A

Conditioning

Nausea and vomiting

Loss of appetite

Diarrhoea

Sexual problems

Stress

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11
Q

What are examples of psychological problems presenting as GI disease?

A

Stress

Anxiety

Depression

Somatisation

Eating disorders

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12
Q

What are examples of drugs that can cause GI problems?

A

Opiates

Amphetamines

Cocaine

Anticholinergics

Antidepressants

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13
Q

What is refeeding syndrome?

A

Metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved, severely malnourished or metabolically stressed due to severe illness

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14
Q

When does adaptive starvation occur?

A

Reduced intake of carbohydrates

Reduced secretion of insulin

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15
Q

What are the main sources of energy during adaptive starvation?

A

Fats and proteins

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16
Q

How does intra and extracellular phosphate change in adaptive starvation?

A

Intracellular phosphate is reduced

Extracellular phosphate may be normal

17
Q

What are consequences of adaptive starvation due to low expenditure of energy?

A

Lethargy

Lack of physical activity

Atrophic gut, heart and muscles

Low micronutrient reserves

18
Q

What does refeeding with carbohydrates cause in someone with adaptive starvation?

A

Rapid rise in insulin

Rapid generation of ATP

Phosphate moves into cells

Hypophosphataemia rapidly develops

19
Q

What is the criteria for determining people at high risk of developing refeeding problems?

A
20
Q

What things are considered when deciding if someone is at risk of developing refeeding problems?

A

BMI

Unintentional weight loss

Little or no nutritional intake

Low levels of potassium, phosphate or magnesium prior to feeding

21
Q

What is the treatment for refeeding syndrome?

A

Correct fluid depletion (cautiously)

Thiamine at least 30 minutes before feeding starts

Feed at 5-10 kcal/kg over 24 hours

Gradual increase to requirement over 1 week

22
Q

At what rate should people with refeeding syndrome be fed?

A

5-10 kcal/kg/ over 24 hours

Gradual increase to requirement over 1 week

23
Q

What should be remembered about disordered eating and eating disorder?

A

They are different

24
Q

What are examples of conditions that produce disordered eating?

A

Crohn’s

Coeliac disease

Missing false teeth

25
Q

What are the different categories of eating disorders?

A

Binge eating disorder

Bulminia nervosa

Anorexia nervosia

26
Q

What is a binge eating disorder?

A

Binges

Gain weight

27
Q

What is bulminia nervosa?

A

Restriction

Binges

Normal or near normal weight

28
Q

What are symptoms/signs of anorexia nervosa?

A

Restriction of eating

Obsessive fear of gaining weight

Body dysmorphia (distorted self-image)

Over exercising

Amenorrhoea

29
Q

What is amenorrhoea?

A

Lack of periods in women

30
Q

What are some of the behaviours peopole with anorexia nervosa have in the pursuit of thinness?

A

Self-starvation

Self-induced vomiting

Compulsive activity and exercise

Use of laxatives

Diet pills

Herbal medicines

Deliberate exposure to the cold

31
Q

What are the general principles for managing anorexia?

A

Firm and consistent approach

Team approach (dietitian, ward nurses, decide on mangement as a team)

May need NG feeding

Watch for refeeding syndrome

Get specialist help

32
Q

What are different kinds of specialist help for anorexia?

A

Liaison psychiatry

Specialist knowledge of eating disorders

Knowledge of Mental Health Act

33
Q

What are simple measures for treating eating disorders?

A

IV fluids

Pabrinex (standard multivitamin IV preparation)

Dietetic review

Maybe NG tube

Alimentary System (41 decks)

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