session 7 Flashcards
2 types of diarrhoea
osmotic, secretory
osmotic diarrhoea
the gut lumen contains too much osmotic material due to malabsorption. causes excess water in poo
secretory diarrhoea
too much secretion of chloride or bicarbonate ions causes increased paracellular transport of Na+. water follows, increasing water in poo
causes secretory diarrhoea
infection
what is constipation
when you have to strain, pass hard stools or are unable to pass a bowel movement.
primary causes constipation
normal transit constipation, slow transit constipation and evacuation disorder
secondary causes constipation
medications , physical obstruction, metabolic and endocrine disorders, neurological and myopathic disorders
treatment diarrhoea
psychological support, increased fluid intake, increased activity, increased dietary fibre, fibre medication, laxitives
compare structure of colon to appendix
appendix has complete longitudinal layer of muscle, colon has teniae coli.
3 types acute appendicitis
acute, gangrenous, or perforated
cause appendicitis
obstruction of the appendiceal lumen by either a faecolith or lymphoid hyperplasia. The obstruction causes the intraluminal pressure in the appendix to rise which in turn causes ischaemia in the wall of the appendix. This ischaemia allows bacterial invasion of the wall with necrosis and/or perforation.
what causes atypical presentation of appendicitis
the appendix lies in a retro-caecal position or in the pelvis and so won’t necessarily irritate the parietal peritoneum. causes supra pubic/right sided rectal/vaginal pain
symptoms appendicitis
poorly localised peri-umbillical pain, anorexia, nausea, vomiting, low grade fever
signs appendicitis
fever, tachycardia, lie still, rebound tenderness
treatment appendicitis
open appendicectomy, laparoscopic appendicetomy
what is a diverticulum
mucosa and submucosa herniate through the external muscle layers of sigmoid colon
where do diverticula occur
sites of the major branches of the vasa recta
Diverticulitis definition
inflammation and/or infection of a diverticulum
what is diverticular disease
pain but no inflammation
cause of acute diverticulitis
entrance to diverticula blocked by faeces, inflammation allows bacterial invasion of walll of diverticula, leading to perforation
uncomplicated diverticulitis
inflammation and absecces confined to colonic wall
complicated diverticulitis
larger abscesses, fistula, perforation
symptoms diverticulitis
abdominal pain, fever, bloating, constipation
signs diverticulitis
localised abdominal tenderness, distention, reduced bowel sounds peritonitis
