IBD/Lactose Flashcards
What is inflammatory bowel disease (IBD)? How can it be diagnosed?
refers to 2 chronic inflammatory conditions:
- ulcerative coliitis (UC) = affects the colon
- crohn’s disease = affects any part of the the GI tract
is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract
diagnosed by endoscopy
What happens in ulcerative colitis?
parts of the colon and/or rectum become inflamed and sore
- ulcers can develop on the colon lining and these can bleed or produce mucus
inflamed colon is less able to absorb the liquid
- can lead to a larger volume of watery stools (diarrhoea)
colon cannot hold as much waste as normal
- leading to frequent bowel movements (six or more a day) may occur.
What are symptoms of ulcerative colitis?
vary according to how much of the colon is inflamed and how severe the inflammation is
diarrhoea
- often with blood and mucus, and an urgent need to rush to the toilet
cramping pains in the abdomen
- can be very severe and often occur before passing a stool
tiredness and fatigue
anaemia
- UC can interfere with the production of red blood cells
- loss of blood
- no eating well/reduced appetite
feeling generally unwell
- some people may have a raised temperature and feel feverish, with a fast heartbeat
loss of appetite and loss of weight
What happens in Crohn’s disease?
crohn’sdisease causes ulceration and inflammation
- affects the body’s ability to digest food, absorb nutrients and eliminate waste
can affect any part of the gut, but is most likely to develop in the ileum (the last part of the small intestine) or the colon
areas of inflammation are often patchy, with sections of normal gut in between
may also penetrate deeper into the bowel wall causing abscesses and fistulas (abnormal connection between two body parts)
What are symptoms of Crohn’s disease?
abdominal pain
diarrhoea
- sometimes mucus, pus or blood is mixed with the diarrhoea
tiredness and fatigue
feeling generally unwell
- some people may have a raised temperature and feel feverish, with a fast heartbea
mouth ulcers
loss of appetite and loss of weight - associated with flare-ups anaemia - loss of blood - no eating well/reduced appetite
What causes inflammatory bowel disease?
genetic predisposition and then environmental triggers:
- viruses
- bacteria
- diet
- stress
What are the main classes of drug used to treat IBD?
aminosalicylates (5-ASAs)
- reduce inflammation in the lining of the intestine
= mesalazine, sulphasalazine and balsalazide
corticosteroids (steroids)- 1st line in adults
- block the substances that trigger allergic and inflammatory responses in your body.
= prednisolone, prednisone, budesonide, hydrocortisone and beclometasone dipropionate
immunosuppressants
-suppress the immune system, and reduce levels of inflammation
= azathioprine, mercaptopurine (6-MP) methotrexate, ciclosporin
- are often used in patients who relapse when they come off steroids.
biological drugsare the newest group of drugs used to treat IBD
- anti-TNF drugs (infliximab, adalimumab and golimumab) target a protein in the body called TNF (tumour necrosis factor), preventing inflammation.
biological drug is vedolizumab (Entyvio)
- stops white blood cells from entering the lining of the gut and causing inflammation
How can surgery be used to treat IBD?
can remove the part of the bowel that’s making patient feel unwell
- if a lot of bowel is removed, you may need a stoma bag
What is lactose intolerance?
is when someone has difficulty absorbing & digesting lactose
- usually the result of your body not producing enough lactase
lactase normally produced in your small intestine
How is lactose normally broken down? How does lactose cause the symptoms of lactose intolerance?
lactase in your small intestine should break lactose down into sugars called glucose and galactose
- these are then absorbed into your bloodstream
if there’s not enough lactase, the unabsorbed lactose moves through your digestive system to your colon (large intestine)
- bacteria in the colon break down the lactose, producing fatty acids and gases like carbon dioxide, hydrogen and methane.
- the breakdown of the lactose in the colon, and the resulting acids and gases that are produced, cause the symptoms of lactose intolerance
=flatulenceand bloating
What are the causes of lactase deficiency?
primary cause
- develops when lactase production decreases as your diet becomes less reliant on milk and dairy products
= genetic component
secondary cause
- shortage of lactase caused by a problem in your small intestine
= could be the result of another condition or medication (gastroenteritis, coeliac disease, IBD, chemotherapy, long courses ofantibiotics)
sometimes only temporary, but it may be permanent if it’s caused by a long-term condition
congenital lactase deficiency
- found in newborns/produce little or no lactase
= autosomal recessive gene (both parents)
What are symptoms of lactose intolerance?
flatulence diarrhoea bloated stomach stomach cramps/pains stomach rumbling feeling sick
What are treatments for lactose intolerance?
no cure for lactose intolerance except cutting down on food and drink containing lactose
- usually helps to control the symptoms
can take lactase substitutes
- are drops or tablets that can be taken with meals or drinks to improve digestion of lactose
