Small Bowel Diseases Flashcards
Symptoms
Weight loss Increased appetite Bloating Fatigue Diarrhoea Steatorrhoea
Signs of Specific Nutrient Deficiencies
Vit A - night blindness Vit B: Thiamine - memory, Niacin - dermatitis, unexplained HF Vit C - scurvy Vit D, Ca, Mg - osteomalacia, tetany Vit K - Raised PTR
What small intestinal diseases can clubbing be a sign of
Coeliac and Crohns
What diseases can scleroderma be a sign of
systemic sclerosis
What small intestinal diseases can aphthous ulceration
Coeliac and crohns
What is dermatitis herpetiformis
a cutaneous manifestation of coeliac disease where IgA deposits in skin causing itchy blisters on the scalp, shoulders, elbows and knees
Investigations for small bowel disease
Small bowel biopsy with endoscopy
White cell scan
Imaging Investigations for small bowel disease
Small bowel study with barium
CT scan
MRI enterography (younger IBD patient)
Tests for bacterial overgrowth
H2 Breath test
Duodenal / jejunal aspirate culture
Serology tests for coeliac
- Total IgA
- IgA transglutaminase antibody (IgA tTG)
- IgA endomysial antibodies (if tTG is weakly +ve)
Coeliac serology tests to do incase of IgA deficiency
IgG
Goldstandard diagnostic test for coeliac
Distal duodenal biopsy showing villous atrophy
Why does villous atrophy occur in coeliac?
gluten produces an inflammatory response via tissue transglutaminase (thought to be).
this leads to villous atrophy and increased intra-epithelial lymphocytes
What is coeliac disease
sensitivity to gluten causing the small intestine to become inflammed and unable to absorb nutrients
which fraction of gluten is the sensitivity to and which foods is it found in?
a-Gliadin
Wheat, rye and barley
