Psychological Aspects of GI Disease/Eating Disorder Flashcards
multifactorial aetiology of GI disease
Motility Gut hormones Gut microbiome Diet Increased visceral sensation Psychological factors.
psychological problems caused by GI disease
Conditioning Nausea and vomiting Loss of appetite Weight loss Diarrhoea Sexual problems “Stress”
psychological problems presenting as GI disease
Stress Anxiety Depression Somatisation Eating disorders
appropriate investigations
Full blood count (FBC) Biochemical profile Blood glucose Pregnancy Test Urinalysis / culture Helicobacter pylori (H. pylori) status Antiendomysial antibody (EMA) (tTG) Erect Chest Xray (CXR) Abdominal film (AXR) Ultrasound scan (USS) Endoscopy (UGIE) Might need CT Head or abdomen Porphyrin screen Short synacthen
how is the body adapted after starvation?
reduced intake of carbs
reduced secretion of insulin
what happens when someone refeeds with carbohydrates?
rapid rise in insulin
rapid generation of ATP
phosphate moves into cells
hypophosphataemia rapidly develops
treatment for peopole refeeding
Start slow.
Correct fluid depletion [cautiously]
Thiamine at least 30 mins before feeding starts
Feed @ 5 - 10 kcal/kg over 24 hrs
Gradual increase to requirement over 1 week
what conditions produce disrdered eating?
Crohns
Coeliac disease
Missing False teeth
what is binge eating disorder?
Binges, purging
But fail to compensate
Gain weight
what is bulimia nervosa?
Restriction
Binges
Purging
Normal or near normal weight.
what is anorexia nervosa?
Restriction Significant weight loss Obsessive fear of gaining weight Perfectionism Significantly impaired decision making (SIDMA) Body dysmorphia Distorted self image Over exercising Amenorrhoea
management principles of eating disorders?
Listen to patient carefully Treat symptoms seriously Reach a firm diagnosis. Explain “Functional” Disease Emphasise it is a real diagnosis. Software versus hardware faults Manage the underlying disease.
