Gastroentrology

Question 1

What are the 2 types of examples of IBD?

Answer 1

Crohn’s disease and ulcerative colitis

Question 2

what are the 3 main interacting co-factors of IBD?

Answer 2

environmental (smoking, stress, hygiene), genetic susceptibility and host immune response (defective mucosal immune system)

Question 3

what cancer does UC have an association with?

Answer 3

Colorectal cancer

Question 4

what are the symptoms of IBD?

Answer 4

• diarrhoea
• abdominal pain
• blood (PR – per rectum)
• mucous
• urgency (sudden need to defecate)
• nocturnal symptoms (waking up in middle of night)
• weight loss
• fatigue
• nausea/vomiting
• bloating
• perianal symptoms
• extra intestinal manifestations
• skin lesions
  (Crohn’s known to affect genital area)

Question 5

what medications can be given for IBD?

Answer 5

corticosteroids
immunomodulators - affects the whole immune system so could make pt at increased risk of developing infections
biologics

Question 6

what can immunomodulators increase the risk of?

Answer 6

cancers and lymphomas

Question 7

what is coeliac disease?

Answer 7

immune response to gluten from the diet

Question 8

what are common oral presentations of coeliac disease?

Answer 8

mouth ulcers aphthae, dermatitis herpetiformis (skin manifestation), angular cheilitis etc

Question 9

how would you test for coeliacs?

Answer 9

blood test for certain proteins

Question 10

what is the most common bacterial infection in the enteric system?

Answer 10

pseudomembranous colitis from C.difficile

Question 11

how can we prevent C.difficile?

Answer 11

1. use antibx responsibly (preferably only after culture and sensitivities are available - so avoid empirical therapy
2. good hygiene
3. regularly clean surfaces in hospital to try and reduce transmission