GI motility disorders Flashcards
what are the primary causes of motility disorders?
gastroparesis
acute / chronic intestinal pseudoobstruction
what is the main functional disorder of motility disoders?
IBS
what is the etiology of the primary motility disoders?
impaired control of neuromuscular apparatus of the gut
what are the interstitial cells of cajal?
pacemaker cells of the gut
how can paraneoplastic syndromes cause dysmotility?
auto antibodies
initial evaluation of GI dysmotility should involve a historical emphasis on what areas?
FMH, meds, ROS
what tests are used to exclude mechanical obstruction?
EGD - esophagogastroduodenoscopy
barium swallow
CT abdomen
what test is performed after obstruction has been ruled out? what does it test for?
scintigraphy
confirmation of gastric and/or small bowel dysmotility disorder
if small bowel dysmotility is confirmed with scintigraphy, what test is then used? what does it test?
gastroduodenal manometry
differentiation of neuropathic from myopathic etiologies
how does neuropathic dysmotility manifest on gastroduodenal manometry?
contractions of normal amplitude but abnormal contractile pattern
how does myopathic dysmotility manifest on gastroduodenal manometry?
low average amplitude of contractions
what are the diagnostic criteria for IBS?
recurrent abdominal pain or discomfort at least 3 days per month during the previous 3 months and associated with two of the following
relieved by defecation
onset associated with a change in stool frequency
onset associated with a change in stool form or appearance
what are the four bowel patterns in IBS?
IBS-D: diarrhea predominant
IBS-C: constipation predominant
IBS-M: mixed diarrhea and constipation
IBS-A: alternating diarrhea and constipation
what is important to focus on prior to diagnosing IBS?
ruling out organic disease
how the pain characterized in IBS?
diffuse without radiation
LLQ
