Altered bowel habit Flashcards
(33 cards)
What is coeliac disease?
Systemic autoimmune disorder triggered by gluten peptides.
Genes associated with coeliac?
HLA-DQ2 or -DQ8
Symptoms of coeliac?
Diarrhoea Bloating Abdo pain Anaemia Dermatitis herpetiformis Osteoporosis Fatigue Weight loss Dental enamel hypoplasia Cerebellar ataxia
Atypical coeliac disease?
Lack GI symptoms
Present with deficiency states or extra intestinal manifestations
Silent coeliac disease?
Serological and histological evidence of disease but no symptoms, signs or deficiency sates
Non-responsive coeliac disease?
Fails to improve within 6 months of gluten withdrawal
Diseases associated with coeliac?
T1 diabetes
Autoimmune thyroid disease
What is dermatitis herpetiformis?
Puritic papulovesicular rash associated with coeliac disease
Investigations for coeliac?
IgA-tTG - tissue transglutminase
Endomysial antibody
IgG DGP - deaminated gliadin peptide
Biopsy - villous atrophy,, crypt hyperplasia, lymphocytic infiltration
Complications of coeliac disease?
Osteoporosis
Malignancy
Pancreatits
Define diarrhoea?
Three or more liquid stools a day or stools that are more frequent than what is normal for the individual
Acute diarrhoea?
<14 days
Persistent diarrhoea?
> 14 days
Chronic diarrhoea?
> 4 weeks
Inflammatory diarrhoea?
Associated with infection, ischemia and IBD Mucoid/blood present Tenesmus Fever Crampy abdominal pain Small in volume Frequent bowel movements GI histology abnormal
Non-inflammatory diarrhoea?
Watery, large volume
V frequent - >10-20 per day
No other symptoms
GI histology preserved
Examples of non-inflammatory diarrhoea?
Secretory - enterotoxins, laxatives, hormonal agents
Osmotic - maldigestion, malabsorption
Causes of non-infectious acute diarrhoea?
Anxiety Allergies Appendicitis Radiation enteritis Ischemia Acute presentation of chronic bowel conditions Drugs
Drugs causing diarrhoea?
Antibiotics Antactids Quinidine Beta blockers Hydochlorothiazide NSAIDs Chemotherapy drugs Antiretroviral drugs Acid reducing agents
Common pathogens causing diarrhoea?
Salmonella Campylobacter Vibrio cholera Shigella E. coli C. difficile C. perfringens
Causes of chronic diarrhoea?
Irritable bowel syndrome Infection - giardia, cryptosporidium, entamoeba histolytica IBD Colitis Coeliac Malabsorption Malignancy Diverticular disease Neuropathy Laxative use
What is factitious diarrhoea?
Laxative abuse causing deliberate diarrhoea
What is microscopic colitis?
Type of inflammatory bowel disease
Watery diarrhoea
Normal colonoscopy
Abnormal histology
What can cause malabsorption?
Chronic pancreatitis Gastrectomy Tropical sprue Lactose intolerance Bacterial overgrowth Lymphoma Cystic fibrosis
