Functional Bowel Disorders Flashcards Preview

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Flashcards in Functional Bowel Disorders Deck (30):
1

What is the basic feature of functional bowel disorders?

Pain or discomfort referred to the GI tract with altered bowel function

2

When does bowel function become abnormal?

When it is abnormal for the specific patient and is causing symptoms

3

Why can functional bowel disorders be difficult to detect and diagnose?

They have no/very little detectable pathology

4

Give 4 examples of functional bowel disorders

Oesophageal spasm
Non-ulcer dyspepsia
Biliary dyskinesia
Irritable bowel syndrome
Slow transit constipation
Drug related

5

If vomiting occurs immediately after eating, what is the cause likely to be?

Psychogenic

6

If vomiting occurs 1 hour or more after eating, what is the cause likely to be?

Pyloric obstruction or motility disorders

7

If vomiting occurs 12 or more hours after eating what is the cause likely to be?

Obstruction

8

Give the causes of functional bowel disorders

Drugs
Pregnancy
Migraine
Cyclical vomiting syndrome
Alcohol

9

What lab investigations might be done in functional bowel disorders?

FBC
Blood glucose
U&Es
LFTs
Ca
CRP
Stool culture
Calprotectin
Thyroid status
Coeliac serology

10

What imaging investigations might be done in functional bowel disorders?

Proctoscopy
Sigmoidoscopy
Endoscopy
Colonoscopy

11

How should non-ulcer dyspepsia be treated if H. pylori and other investigations are negative?

Symptomatically

12

What are the classes of causes constipation?

Systemic
Neurogenic
Organic
Functional

13

Give an example of a systemic cause of constipation

Diabetes mellitus
Hypothyroidism
Hypercalcaemia

14

Give an example of a neurogenic cause of constipation

Autonomic neuropathies
Parkinson's disease
Stroke
MS
Spina bifida

15

Give an example of an organic cause of constipation

Strictures
Tumours
Diverticular disease
Proctitis
Anal fissure

16

Give an example of a functional cause of constipation

Megacolon
Idiopathic constipation
Depression
Psychosis
Institutionalisation/Admission (due to decreased mobility)

17

Give an example of how functional bowel disorders can cause psychological factors

Huge impact on quality of life
Major cause of work absences
Affects ability to do normal day-to-day tasks
Can cause incontinence

18

What do alarm symptoms suggest?

Severe disease and need for further investigation

19

Give examples of alarm symptoms

Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Melaena/ Haematemesis
Swallowing difficulty
Vomiting
Age > 50
Rectal bleeding
Abdominal mass

20

What is nausea?

The sensation of feeling sick

21

When should treatment for functional bowel disorders be started?

After a firm diagnosis has been reached

22

What drug therapy can be given for pain in functional bowel disorders?

Antispasmotics
Linaclotide
Antidepressants

23

What drug therapy can be given for bloating in functional bowel disorders?

Some probiotics
Linaclotide

24

What drug therapy can be given for constipation in functional bowel disorders?

Laxatives
Linaclotide
Softeners
Osmotics

25

What drug therapy can be given for diarrhoea in functional bowel disorders?

Anti motility agents
FODMAP diet

26

What psychological intervention can be given in functional bowel disorders?

Relaxation training
Hypnotherapy
Cognitive behavioural therapy
Psychodynamic interpersonal therapy

27

For what patients is relaxation training most effective?

Patients with diarrhoea or psychological co-morbidity

28

For what patients is hypnotherapy most effective?

Refractory patients

29

For what patients is cognitive behavioural therapy not effective?

Patients with depression or patients who believe that the cause of their symptoms is physical

30

For what patients if psychodynamic interpersonal therapy most effective?

In patients with a history of abuse