5 - GI Disorders Flashcards
GI Disorders - basic concepts
- components of GI tract (3)
- main functions
- common symptoms
Liver, pancreas, gallbladder
Absorb nutrients, eliminate waste
Abdominal pain, nausea, vomiting, diarrhea, bleeding, jaundice
IBD
- describe
- 2 main types
Chronic, immune-mediated intestinal inflammation
Crohn’s
Ulcerative colitis
IBD
-describe crohns
May affect any part of tract
Patchy areas of damage, healthy tissue in b/w
Full-thickness inflammation of intestinal wall
IBD
-describe ulcerative colitis
Limited to large intestine and rectum
Continuous areas of damage
Only lining of intestinal wall inflamed
IBD
- cause
- presentation
Inappropriate immune response + environmental/genetic factors
Persistent diarrhea, ab pain, bleeding, weight loss, fatigue
IBD
- dx
- tx
Endoscopy/other imaging
Stool samples and/or blood tests
Medications - steroids, immunomodulators, biologics
-biologics = mainstay, injected, TNF alpha modulator
Surgery if needed
-inflamm severe enough to cause erosion -> part of tract removed
IBD
- vs IBS
- vs celiac disease
IBS: functional disorder characterized by ab pain/discomfort and altered bowel habits (-) detectable structural abnormalities
CD: similar symptoms, characterized by inflammation, but has a known/specific cause (go away if avoided)
IBD
-main concern for ODs
RED EYES
Most common = episcleritis (blanches with phenyl, tx with topical NSAIDs/steroids - systemic tx of IBD should cover tx of this)
Scleritis (likely with overlying epi)
- possibly affecting vision
- topical tx not enough, need systemic
Uveitis (esp anterior, acute)
- not assoc with flare-ups of IBD
- can be a first sign of a GI disorder pt is unaware of
IBD
-secondary concern for ODs
Medications
- steroids
- avoid rxing NSAIDs (esp oral) until checked with gastroenterologist
Behcet’s
- describe
- presentation
Auto-inflammatory/immune systemic vasculitis (all sizes/types)
Probably triggered by environmental exposure
20’s/30s, from mid/far east (Turkey -> Japan)
Behcet’s
- diagnosis
- treatment
Dx = clincal - no tests
-recurrent oral (aphthous) ulceration plus 2 of:
—recurrent genital ulceration
—ocular/skin lesions
—positive pathergy tests (abnormal rxn of swelling)
HLA-B51 is a risk factor
Tx = generally steroids for acute disease, quick shift to immunosuppressives for control of active disease and maintenance of remission
Behcet’s
- importance of ocular concerns
- rarely, __ is an issue
May lead to blindness
Cerebral vasculitis
Behcet’s -ocular signs/symptoms —laterality —AC —retina - vascular, end-stage
Usually bilateral (may have to refer to LV)
Hypopyon = anterior uveitis
BRVO
-vasculitis in other condns is usually either arteritis or phlebitis, but not both/either like Behcet’s
End-stage = severe optic atrophy, gliosis (ghost vessels), retinal atrophy with pigmentary changes
FAP (familial adenomatous polyposis)
- describe
- presentation
AD genetic defect of adenomatous polyposis coli (APC) gene -> numerous colorectal polyps -> cancer
Numerous adenomatous polyps arise post-puberty
Most asymptomatic until develop cancer (35-40 yo)
FAP (familial adenomatous polyposis)
-spectrum of disorders (2)
Gardner syndrome
-polyps (+) osteomas of head/mandible, CHRPE-like lesions (histologically different)
Turcot syndrome
-polyps (+) brain tumors
