GI Disorders II Flashcards by Sarah Heath

What is celiac disease triggered by

GLUTEN:
Barley
Rye 
Oats 
Wheat

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Number 1 autoimmune disorder in the US

Celiac disease

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How much of the population has celiac disease

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Immune response in Celiac disease

T cell mediated immune response, increases level of Ab

-related to other autoimmune disorders

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Most patients with celiac disease are

Genetically predisposed

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Do all clerical disease patients have symptoms?

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Symptoms of Celiac

Diarrhea, either constant or off and on
Abdominal pain
Bloating

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Other symptoms of celiac

Irritability or depression

Skin rash

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How do you distinguish Celia disease from other GI problems

Skin rash

-herpes rash

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Dx of Celiac disease

History important
Sero test: IgA: anti tTG increased
Biopsy to confirm

Gut is flattened
BROW flattened

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Treatment for celiac disease

Regeneration of gut lining with gluten free diet

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What percent of African american have lactose intolerance

75%

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What percent of Asian Americans have lactose intoleracne

Asian Americans

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Lactose not broken down, produces gas

Lactose intolerance

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How to manage lactose intolerance

Limit amount of milk and dairy products and give them other nutrients to bring them back to health

maintain protein and energy intake
eat yogurt with live active cultures

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Two related chronic inflammatory disorders

Chrons disease and ulcerative colitis

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When do you see chrons disease and ulcerative colitis

Teen to 30s

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Location of crohns

Any potion of the GI tract, rectal sparing

SKIP lesions

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Location of ulcerative colitis

Colon
Continuous inflammation
Rectal involvement

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Relapse in chrons and ulcerative colitis

Can occur

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Pain in crohns

Common in lower right abdomen

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Pain in ulcerative colitis

Lower left abdomen

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Morphology of crohns

Colon all is thickened

Transmural inflammation: cobblestones mucosa, ulcers, and fistulas

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Morphology of ulcertive colitis

Colon wall is thinner
Mucosal inflammation
Pseudopolyps
Crypt absences and ulcers

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Complications of crohns

Strictures, fistfuls, perinatal disease | Malabsorption, and nutritional depletion

Complications of ulcerative

Severe stenosis, toxic megacolon, colorectal carcinoma

Bleeding in crohns

Bleeding from rectum during movement is uncommon

Bleeding in ulcerative colitis

Bleeding from rectum during bowel movement is common

Ocular findings for crohns

Non-granulomatous uveitis | Prevalence: 1-10%

Ocular findings in ulcerative colitis

Non-granulomatous uveitis | Prevalence: 1-5%

Uveitis related to inflammatory bowel disease

Can occur in Crohn’s disease and ulcerative colitis May be the initial complaint

Tx for crohns and ulcerative colitis

Antiinflammatory agents Immunosuppressive agents Steroids Surgery

Prognosis for chrons and ulcerative colitis

Chronic condition requiring constant monitoring

Chronic, recurrent functional abdominal disroders

Irritable bowel syndrome (IBS)

Epidemiology of IBS

5-10% US population with peak at 20-29 years of age

What is the the only bowel disorder that is highest in females

IBS

What is IBS more common in

Females Trigger is stress, psychological or physical Food: processed food, high fructose corn syrup and milk formulas in infants antibiotics

Recurrent abdominal pain or discomfort 3 days/month for past 3 months with symptoms of >6 months associated with 2 or more of the following in IBS:

Pain relief with defacation Change in bowel habits Change in stool form

Tx of IBS

- stress management - no special diet just increase fiber - avoid: fatty foods, gas-producing foods, alcohol and caffeine - drugs: antispasmodic, anticholinergic, serotonin antagonsit

Acquired hernitations of the colonic mucosa and submucosa through the uscularis propriety

Diverticulosis (pseudo or false)

Where does diverticulosis most commonly occur

In the sigmoid colon and can vary in size and number, although typically they are between 5 and 10mm in diamter

Refers to the presence of diverticula in an individual who is asymptomatic, whereas ________ refers to the presence of diverticula associated with symptoms which occur is in 20% of individuals

Diverticulosis | Diverticular disease

Diverticulosis and age

More common in old age

Symptoms of diverticulosis

Abdominal pain (LL quad) Nausea and vomiting Tenderness Fever

Dx of divertovculoiosis

History Barium enema Ct scan Ultrasound

Complications of diverticulosis

- diverticulitis - perforation with peritonitis - abscess - hemorrhage - bowel obstruction - fistulas

What is he worst symptom of diverticulosis

Fistulas with bladder pneumoturia: feels like passing air with urine

Peak incidence of appendicitis

10-19 yeats

Pain in appendicitis

Periumbilical pain: dull and steady

Differentiate crohns from appendicitis

Appendicitis has rebound pain air tenderness when pressing on it

Progression of appendicitis

Progresses over 4-6 hours and localized to right lower quadrant

What si the hallmark of appendicitis

Rebound pain or tenderness

Dx of appendicitis

1: clinical signs and symptom 2: WBC count > 10,000 3. Ultrasound 4. Exploratory laparotomy 5. Ct Shane

Complication of appendicitis

Sudden pain relief may indicate rupture of appendix and may lead to peritonitis

Treatment for appendicitis

Surgery

Number one cancer of GI

Colorectal cancer

Peak age of colorectal cancer

60-70

How many people get colorectal cancer before age 50

20%

How many people die per year of colorectal cancer

1/3rd of them die

Risk factors for colorectal cancer

- age - family history - chrons or iulcerative colitis - familial adenomatous polypososis - diet

Pretoection against colorectal cancer

Vit A, C, E

Number one cause of cancer

A benign cancer

Colon cancer presentation

- symptoms later in course of disease - bleeding: highly significant early symptom - other less alarming symptoms include: change in bowel habits, diarrhea constipation, sense of urgency, sense of incomplete emptying, PAIN is usually a late symptom

Stage I colorectal cancer growth

Submucosa

Stage II

Muscualris layer

Stage III

Beyond msucularis and nodes

Stage IV

Metastasis

Stage I TX

Complete surgical removal

TX for stage II and III

Decrease size of tumor with radiation and then do surgery

Stage IV treatment

Use all resources, but surgical removal first step and then chemo therapy and radiation

DX and TX of colorectal cancer

- barium imagining - colonoscopy with biopsy - CT Scan - MRI and ultrasonography TX is surgical removal

Prognosis of colorectal cancer

4TNM stages - stage I: t5 year survival rate of 90-100% - stage IV (metastatic) poor prognosis

What is key to preventing colorectal disorders

Prevention | -fresh, healthy diet, avoid irritants

Significant symptom in gut disorders

Bleeding in stool

All of the following play a role in irritable bowel syndrome expect

Abnormal GI motility | -it’s a functional disorder

Achalasia can lead to what cancer

Esophageal squamous cell carcinoma

GI Disorders II Flashcards

(76 cards)