week 9 - metabolic disorders 1 Flashcards
What is the GI tract responsible for?
Absorbing dietary water, minerals and digestive products
Conserving water, minerals to maintain body fluid/physiological homeostasis
What is the distal colon involved in?
It is involved with the storage/elimination of undigested foods, bile, bacteria
What is cholestasis?
Any condition in which the flow of bile from the liver is slowed or blocked
What is gastroparesis?
A chronic condition where the stomach cannot empty in the normal way
What is Ogilvie’s syndrome?
distension of the colon that is similar to that occurring as a consequence of bowel construction but in which no physical obstruction exists
What is peptic ulcer disease? STOMACH DISEASE
It is a break in the lining of the GI tract extending to the muscular layer of the GI wall.
It occurs when there is an imbalance between factors that protect the mucosa of stomach/duodenum.
Can be caused by too much acid in the stomach
This imbalance is commonly caused by presence of H. pylori or NSAID use
What symptoms can generate from ulcers?
Vomiting or vomiting blood
Breathing issues
severe anaemia
High pulse or low blood pressure
Faeces with dark blood
Weight loss
Appetite changes
What is the most common complication caused by ulcers?
Internal bleeding - Can happen when an ulcer develops at the site of a blood vessel.
Can lead to anaemia
What are the main types of NSAIDS
Ibuprofen
High dose aspirin
How can NSAIDS damage the epithelium?
What is H. Pylori?
Gram negative spiral shaped bacillus found in mucous layers of those that have the ulcers.
Transmitted person to person by saliva. Also by faecal contamination of food an water.
How can H. Pylori actually cause issues in the body?
How can you diagnose peptic ulcer disease?
Endoscopy
Patient history
Non invasive H. pylori testing: carbon 13 urea breath test, serum antibodies to H. pylori., stool antigen test.
What is the stool antigen test?
It looks for antigens associated with H. pylori infection in the stool.
What is a stool PCR test?
Can detect H. pylori infection in stool, can also identify mutations that maybe resistant to antibiotics that are used to treat H. pylori
How can you treat peptic ulcer disease?
Lifestyle advise such as stopping smoking.
Avoiding NSAIDS
Patients can be started on Proton Pump inhibitor for 4-8 weeks to reduce acid production
Positive H. pylori requires eradication therapy
What is eradication therapy aka triple therapy?
Treatment consists of:
1. proton pump inhibitor
2. oral amoxycillin
3. clarithromycin or metronidazole
What does the hormone gastrin do?
It controls the amount of acid in the stomach
What is a gastrinoma? (IN THE STOMACH)
It is a rare tumour that start in the cells that make the gastrin hormone,
How do gastrinomas arise?
Due to uncontrolled cell division of G cells (secrete gastrin) in the gut
How does gastrinoma cause disease?
- The tumour cells release excessive amounts of gastrin
- This leads to hyperplasia (too much growth) of parietal cells so increases amount of gastric acid
3., Too much gastric acid breaches the mucosal defences of the gut etc - This causes ulcers etc
What is Zollinger - Ellison syndrome (ZES)?
It is the combination of 3 things:
1. High levels of gastrin
2. too much acid
3. stomach or small bowel ulcers
Increases the chance of peptic ulcers
How are gastrinomas diagnosed?
One things that may indicate that one has a gastrinoma is an elevation of FSG levels, indicating high gastric acid secretion,
Another way is where the individual is administered with secretin. Then FSG levels are measure at specific time points. This is because secretin stimulates gastrin release if one has a gastrinoma, but in patients without gastrinoma, secretin inhibits the release of gastrin.
Another way is carrying out the calcium infusion test, this is because calcium has been known to produce an increase in gastrin levels in patients with a gastrinoma. Therefore, after taking the calcium, if the gastrin levels increase then it’s most likely the patient has a gastrinoma.
Can also use CT scans and biopsies
What are the treatments for gastrinoma?
Surgery
Chemotherapy if the tumour has spread to other parts of the body.
Toi stop you from making too much gastric acid you can have drugs called proton pump inhibitotrs
