Gastro II Flashcards
How may crohns and UC present?
- Abdominal pain
- Diarrhoea
What is a complication of UC and crohns?
Toxic megacolon
What can crohns present? Where does it typically present?
Anywhere along the GI tract. Terminal ileum -skip lesions.
What are some complications of Crohns?
- Strictures
- Adhesions
- Fistulae
- Abscesses
What is Crohns defined as in terms of pathophysiology?
Transmural inflammation with non-caseating granulomas
List 5 presenting features of Crohns:
- Diarrhoea
- Abdo pain
- Bloody diarrhoea with colitis
- Growth failure/delayed puberty
- Systemic: anaemia, fever, poor appetite
What investigators may be performed in Crohns and what might there results be?
- FBC - anaemia
- CRP and ESR - raised
- Stool culture - negative
- Barium follow-through: thickening of bowel wall, strictures, cobblestone mucosa, rose thorn ulcers
- Colonoscopy and biopsy
What is the Rx of Crohns?
- Elemental diet for 6 weeks in induce remission
- Anti-inflammatory aminosalicylates (sulfasalazine)
- Steroids to prevent relapse
- Infliximab (anti-TNF)
- Surgery
Give an example of a aminosalicylate:
Sulfasalazine
Give 4 features of functional abdominal pain:
- child is well between attacks
- No weight loss/faltering growth
- No blood in stool or perianal disease
- Examination normal
What investigation would be performed in suspected functional abdominal disease to rule out other pathologies?
- Urine dip/MSU (exclude UTI and renal disease)
- FBC, ESR, CRP (exclude inflammatory bowel disease)
- Stool culture
- Coeliac screen (total IgA, anti-TTG, anti-endomysial Ab)
What is the management for functional abdominal pain?
Supportive;
- Acknowledge the pain is real
- Explain why it happens
- Any links to family issues?
How should constipation be managed?
- ^fluid + fibre intake
- Laxatives: osmotic (macrogol), stimulant (senna)
What is hirshprungs?
Absent parasympthetic bowel
What can hirshprungs present as?
- Acute distention
- Chronic obstruction (>48hrs to pass meconium)
- Faltering growth
