Psychological aspects of GI disease

Question 1

What are the psychological factors in acute organic disease?

Answer 1

Patient's perception
Cancer fears
Confusion between IBS and IBD
Sensitivity vs allergy
Restriction diets

Question 2

What are the psychological factors of chronic organic disease?

Answer 2

IBD
Surgery
Other progressive condiitons
Cancer

Question 3

What psychological problems can be caused by GI disease?

Answer 3

Conditioning
Nausea and vomiting
Loss of appetite
Diarrhoea
Sexual problems
Stress

Question 4

What psychological problems can present as GI disease?

Answer 4

Stress
Anxiety
Depression
Somastisation
Eating disorders

Question 5

What drugs can have effects on the GI tract?

Answer 5

Opiates
Amphetamines
Cocaine
Anticholinergics
Antidepressants- tricyclics, SSRIs

Question 6

What is adapted starvation?

Answer 6

Reduced intake of carbs cause reduced secretion of insulin
Main sources of energy are fat and protein
Extracellular phosphate may be normal

Question 7

What does sudden referring with carbs after starvation cause?

Answer 7

Rapid rise in insulin and generation of ATP

Phosphate moves into cells and causes hypophosphataemia

Question 8

What are the criteria for determining people at high risk of referring problems?

Answer 8

Low BMI
Unintentional weight loss
Little or no nutrient intake in several days
Low levels of K, phosphate, magnesium
History of alcohol abuse or drugs, including insulin, chemo, antacids or diuretics

Question 9

How are people who have been in a state of starvation treated?

Answer 9

Correct fluid depletion
Thiamine beforee feeding
Feed at 5-10cal/kg over 24 hours
Gradual increase to requirement over 1 week

Question 10

What is the treatment for bulimia and anorexia nervosa?

Answer 10

Dietiian
Avoid bedside arguments
Possible NG feeding
Watch for referring syndrome
Liaison psychiatry