The Physiology of GI Disorders Flashcards
What is sialorrhea and who is mainly affected by this?
- drooling
- affects people with complex neurodisability due to problems with swallowing
What can be given to treat drooling?
- anticholinergic medication
- transdermal scopolamine patches
- botulinum toxin type A injections into parotid and submandibular glands
What are the side effects of anticholinergic medicine?
- drowsiness/sedation
- blurred vision
- dizziness
- urinary retention
- confusion/delirium
- hallucinations
- dry mouth
- constipation
- reduced sweating and elevated temperature
Patients with neurodisabilities or NS problems might struggle to feed, what are the possible interventions to help with this?
- gastrostomy (feeding tube inserted into stomach for patients who struggle with swallowing their food properly)
- jejunal tube feeding (tube inserted into jejunum for patients who struggle to empty their stomach)
What is coeliac disease and its management?
- an autoimmune condition where the small intestines become inflamed when the individual consumes gluten
- results in inadequate absorption and digestion
- its management is to follow a gluten-free diet for the rest of the patient’s life
What are the symptoms of coeliac disease?
- constipation or diarrhoea
- bloating
- stomach pain
- anemia
- weight loss
- fatigue
What is the relevance of GIT physiology in relation to toilet training?
- parents used to rely on the physiological gastrocolic reflex of the GIT after a meal (food causing distension as it makes its way down the GIT makes the bowels move etc)
- gets child to sit on potty after meal
- now focus on waiting on child to feel like they need to use the potty
Normal vomiting in newborns
- can vomit mucus, or occasionally blood-streaked a few hours after birth due to irritation of gastric mucosa from material swallowed during delivery
- vomiting during neonatal period can be due to overfeeding or from failure of infant to let out swallowed air
Abnormal persistent vomiting in newborns
- increased chances of intestinal obstruction and increased intracranial pressure
- maternal polyhydramnios suggests upper GI atresia
- bile-stained vomit suggests intestinal obstruction beyond duodenum
- projectile vomiting: hypertrophic pyloric stenosis (overgrowth of muscle in pylorus which narrows it and doesn’t allow food to move from stomach to duodenum)
- consider allergies/infections
How is a duodenal atresia diagnosis confirmed?
- upright abdo film that shows ‘double bubble’ sign
- dilated stomach and dilated proximal duodenum
What are the 3 possible ways the intestines can become obstructed by malrotation of the gut?
- obstruction of duodenum from congenital peritoneal bands that run over duodenum from caecum in RUQ
- midgut volvulus
- internal hernia in mesentery
How does a small bowel obstruction appear on imaging?
- second part of duodenum appears large and thick and at jejunum
- considerably decreases in size distally at ileum to disappear entirely in distal ileal bowel loops
What is Hirschsprung disease and its presentation?
- most common cause of neonatal colonic obstruction
- characterised by short colonic aganglionosis (absence of ganglion cells)
- presents as failure to pass meconium in first 1-2 days after birth
What is acute pancreatitis and its causes?
- inflammation of the pancreas triggered by release of activated exocrine enzymes into substance of the organ
- causes (BAD HITS):
- biliary
- alcohol
- drugs
- hypertriglyceridemia/hypercalcemia
- idiopathic
- trauma
- scorpion sting
Describe the presentations of acute pancreatitis
- Cullen’s sign: periumbilical ecchymosis (discolouration) from tracking of blood from retroperitoneum to umbilicus
- Grey Turner’s sign: produced by haemorrhagic fluid spreading from posterior pararenal space to lateral edge of quadratus lumborium
