Wk2 - Polycystic Ovarian Syndrome (PCOS) and GI Flashcards

Question

What is GORD?

Answer 1

* occurs when stomach acid frequently flows back into esophagus * acid reflux irritates esophagus lining * mild acid reflux occuring at least 2x/wk. Mod-sev = 1x/wk * can be managed with lifestyle and OTC meds * some require strong meds or surgery

Answer 2

Use to categorise conditions. Adults: 8 domains and 22 sub-domains 5 most common subdomains: IBS, functional dyspepsia, functional constipation, function diarrhea & functional bloating/distention

Answer 3

AKA nervous stomach, irritable colon * muscles of large intestine contract more often than normal * manage with diet, lifestyle and stress * abdominal pain relieved with bowel movement * more-sev Sx Tx with meds and couselling * IBS doesn't change bowel tissue or increase risk of colorectal cancer

Answer 4

* unexplained fullness after meals, unable to finish normal-sized meal, epigastric pain/burning * pain in uppder abdomen with bloating, belching and nausea * no obvious cause! * common / long-lasting * current Tx generally unsatisfactory due to lack of pathophysiological basis * when FD patients have postprandial fullness/early satiety - subclassed as postprandial distress syndrome (PDS) * with epigatsric burning/pain - subclassed as epigastric pain syndrome (EPS)

Answer 5

"Fermented Oligosaccharides, Disaccharides, Monosaccharides And Polyols" * short-chain carbs not absorbed properly in gut * when in small intestine = move slowly, attracting water * when in large instine, fermented by gut bacteria, producing gas Extra gas + water = instestinal wall stretch and expand --> people with IBS causes exaggerated sensations of pain and discomfort

Answer 6

Immune reaction in SI to eating gluten - a protein in wheat, barley and rye - over time, reaction damages SI lining, causes malabsorption - altered gut microbiota -may be responsible Causes: diarrhea, fatigue, weight loss, bloating and anaemia No CURE!! - follow strict GF diet to manage Sx and promote intestinal healing 1y after GF diet - more likely Dx with metabolic syndrome People with Celiac disease on GF diet rep high Tx burden (comparable with end-stage renal disease), up to 30% rep -ve Sx (GI upset) and sleep disturbances

Answer 7

* small, bulging pouches that can form lining of digestive system * commonly found in lower colon * common esp. >40y * when pouch/es become inflammed = diverticulitis Sx: * severe abdominal pain, fever, nausea and change in bowel habits Mild = Tx with rest, diet and antibiotics Sev/recurring = may requir surgery

Answer 8

* 30% of adults >50 y havev GI complaint * IBD ~ 0.3% = 61,000 * 28,000 Crohn’s Disease * 33,000 Ulcerative Colitis * GORD ~ 15% * IBS ~ 20%, 2x more in women/younger individuals. * Coeliac Disease ~ 1.3% (1 in 70) // 80% remain unDx * Incidence 4-5fold over past 50y * Diverticular Disease - 5% in 40y/younger, 65% by 85y

Answer 9

Inflammatory Conditions – A ‘Flare-Up’ * reappearance of Sx * prescribe corticosteroids - reduce immune system to fight inflammation * usually avoid Ex during flare-up – dependant Sx * Mod Ex +vely modulates intestinal immune system while sev Ex is immunosuppressive Mental Health * High levels of poor mental health * Very prevalent in IBS, UC and FD Attributed to... * general psych stress of suffering from chronic/debilitating disease * derangement of GBA involving dysbiosis (microbial imbalance) impacting neurocognitive function.

Answer 10

Sx: nausea, heartburn, diarrhoea, GI bleeding common (20-40%) during Ex, esp. HIIT aerobic endurance activities (esp. long-distance running & triathlon) Sx: * transient, no long term consequences * progressive leading to cessation of Ex or decrease intensity. * Serious Sx limit Ex performance/participation Mechanisms of Ex causing GI Sx not well known: * decreased GI blood flow * increased GI motility * increased mechanical bouncing * altered neuroendocrine modulation

Answer 11

Single bout of long high intensity = gut damage/gut permeability damaged exacerbated in hot environments GI bleeding most serious Repeated GI bleeding = * iron deficiency and anaemia * endotoxaemia * malabsorption * GI inflammation Dehydration exacerbates condition

Answer 12

* decrease risk of colon cancer * retrospective and prospective studies indicate Ex benefits disease course and QoL - reduces GI bleeding - inhibit appetite - functional capacity - general wellbeing by +ve mood changes - sleep - BMD

Answer 13

People with Crohn's Disease completed less mod-vig Ex than controls - long disease duration, low BMI, low VitD3 and inflammation evidenced by elevated serum C-reactive protein associated with low PA - Italisn study - 21% with IBD regularly Ex - Ex rates fluctuate with patient's disease activity

Answer 14

Ongoing GI Sx (e.g. diarrhea), may be hesitant Ex outside of home or in areas without bathroom access Sx exacerbation is another main concern. * 79% rep IBD limited participation * abdominal/joint pain, fatigue, flare-ups and increased fecal urgency * in healthy patients, strenuous, HIIT reduces blood flow to digestive system, can be exacerbated by hypovolaemia due to dehydration --> may be responsible of ischaemic colitis in HIIT endurance athletes (e.g marathoners and triathletes)

Answer 15

72% rep Ex improved Sx 23% rep Ex exacerbated IBD symptoms: - 41% rep fatigue - 12% rep increased toilet needs - 17% rep abdominal pain - increase joint pain, IBD Sx and increased Rx time

Answer 16

* 30mins cycling at 50% peak capacity and HIIT = similar increases in inflammatory markers between IBD and controls * all inflammatory markers returned to baseline within 60mins after Ex session * transient nature of elevations suggest little danger of Sx exacerbation Limited data suggest even HIIT is safe in selected IBD patients.

Answer 17

Cross-sectional Ex (>30mins, 3x/wk) -vely correlated with GORD No studies investigating an Ex intervention

Answer 18

Bowel movements more frequent and colon transit more rapid in PA individuals than sedentary * Systematic review of 14 RCT found * Ex is safe * GI Sx, QOL, anxiety, and IBS-related comorbidities = improvements with Ex compared to usual care * More research needed

Answer 19

* 50% od low PA levels * metabolic bone disease = frequent co-morbidity * ~75% new Dx patients have low BMD and 40% greater risk of fractures * promote weight-bearing and resistance Ex

Answer 20

* People who are inactive will have more GI symptoms associated with their condition *Likely due to increased inflammation when people are sedentary * Unfortunately, there is little high level evidence for benefits of Ex on Crohns’s Disease * It is likely that the ‘right amount’ of exercise will create an anti-inflammatory environment that will improve GI symptoms and quality of life