Small Intestinal Disorders Flashcards
Symptoms of malabsorption
Weight loss Increased apetite Steatorrhoea Diarrhoea Bloating Fatigue
Definition of steatorrhoea
Fatty stool
Features of steatorrhoea
HIGH fat content in stool Stool less dense so floats Pale Foul smelling May leave oily mark
What can clubbing be a non specific sign of (in small bowel disorders)?
Coeliac disease
Crohn’s disease
What can aphthous ulceration be a non specific sign of (in small bowel disorders)?
Coeliac disease
Crohn’s disease
What is dermatitis herpetiformis?
Cutaneous manifestation of coeliac disease
Presentation of dermatitis herpetiformis
Blistering
Intensely itchy
Patients usually scratch them off before you see them as they are intensly itchy
Where do you get dermatitis herpetiformis?
Scalp
Shoulders
Elbows
Knees
Pathology of dermatitis herpetiformis
IgA deposit in the skin
Investigations for malabsorption
Small bowel biopsy - endoscopy Barium study of the small bowel White cell scan CT scan MRI enterography Capsule enterography
What can be used in diagnosis of coeliac disease?
HLA status
What HLA types do 97% of coeliacs carry? What % of normal population carry them?
HLA dq2 or dq8
30%
What happens to the villi in coeliac disease?
Villous atrophy
What % of coeliac in the population are known about?
33%
What do coeliacs have a sensitivity to?
Gliadin fraction of gluten
What is gluten found in?
Wheat
Rye
Barley
Pathology of coeliac disease
Inflammatory response
Partial or subtotal villous atrophy
Increased intra-epithelial lymphocytes
Gold standard diagnostic test for coeliac disease
Distal duodenal biopsy
Investigations for coeliac disease
Distal duodenal biopsy
Serology