Psychological Aspects of GI Disease/Eating Disorders Flashcards
What are the psychological problems that present as GI disease?
Stress
Anxiety
Depression
Eating disorders
Somatisation
Can you give examples of functional GI diseases?
Upper GI
Reflux
Functional dyspepsia
Nausea vomiting syndromes
Intestinal
IBS
Biliary disease
Sphincter of Oddi Dysfunction
What are the different aetiologies of functional GI disease?
Motility
Gut hormones
Gut microbiome
Diet
Increased visceral sensation
Psychological factors.
What are the adverse effects of opiates on the GI tract?
Inhibition of gastric emptying, increases sphincter tone, constipation
What is refeeding symdrome?
During a period of starvation there is reduced intracellular phosphate, extracellular phosphate may be normal
Upon eating carbohydrate - rapid ris in insulin, rapid generation of ATP, phosphate moves into the cells - hypophosphataemia rapidly develops
Who is at risk of developin refeeding problems?
How do you feed someone who is at risk of refeeding problems?
Correct fluid depletion
Thiamin at least 30 minutes before feeding starts
Feed @ 5-10 kcal/kg over 24 hours
Gradual increase to requirement over 1 week
“Disordered eating” and “eating disorders” are different, what are conditions that produce disordered eating?
Crohns
Coeliac disease
Missing False teeth
Give examples of eating disorders
Binge eating disorder
Bulimia nervosa
Anorexia nervosa
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 are the features of anorexia nervosa?
Restriction - significant weight loss
Obsessive fear of gaining weight - perfectionism, SIDMA - significantly impaired decision making
Body dysmorphia - distorted self-image
Over exercising
Amenorrhoea (abnormal abscence of menstruation)
How can patients be conditioned to vomit?
Eating causes reflux, reflux triggers a vomit
