Flashcards in Lower GI Deck (20)
What is acute appendicitis ?
sudden onset inflammation of the appendix
What can cause appendicitis?
- obstruction of appendiceal lumen by a fecalith (poo), calculus, tumour or worms
- this causes an increased intraluminal pressure and bacteria invasion
What is the difference between visceral and parietal pain?
visceral - referred pain, pain in a different location
parietal - pain more localised
What are the symptoms of appendicitis?
- pain centrally and then moves down to the right iliac fossa
What is peritonitis?
when appendix is inflamed it comes into contact with the abdominal wall causing localised peritonitis (inflammation of the peritoneum)
- all the cavity can become inflamed in other conditions
What is the treatment of appendicitis ?
- removing by surgery
- sometime antibiotics
What is anti-biotic associated colitis/ pseudomembraneous colitis?
-Acute inflammation of the colon
- characterised by the formation of adherent inflammatory pseudomembranes overlying the site of mucosal injury
What are the causes of antibiotic associated colitis/ pseudomembraneous colitis?
- c.diff that has over grown after competing bowel organisms were eliminated by broad spectrum antibiotics
What are the symptoms of antibiotic associated colitis/ pseudomembraneous colitis?
- lower abdominal tenderness
What are the treatments for antibiotic associated colitis/ pseudomembraneous colitis?
- consult microbiologist
- stop current antibiotics
- possibly introduce new antibiotics (specific)
- hydrate patient
- move to side room
What is inflammatory bowel disease?
- chronic inflammation conditions of unknown reason affecting the GI tract
- two main forms:
- crohns disease
- ulcerative colitis
What is Crohns disease?
- It affects from mouth to anus
- especially effects ileum and colon
- it is not continuous along tract, more patches that it affects
- transmural inflammation (affects whole thickness of the wall)
What are the complications of crohns disease?
- can have fistula formation
- can fuse bowel to other places ( can get fecal matter passing to other places)
What symptoms may a patient present with in Crohns disease? (includes some complications)
- malabsorption: fat, vitamins A D E K, bile salts
- extra-intestinal: skin, eyes, joints
- increased risk of bowel carcinoma
- bowel obstruction and perforation
What is ulcerative colitis?
- affects colon only
-Starts in rectum spreads proximally
- Continuous disease
(No skip lesions)
- Mucosal disease
(No transmural involvement)
- May involve whole colon
What are the complications of ulcerative colitis?
- Anaemia: iron deficiency from blood loss
- Electrolyte loss from diarrhoea
- Extra-intestinal disease: skin, eyes, joints, bile ducts (PSC)
- Increased risk of carcinoma: related to duration and severity of disease
- Need for surveillance for dysplasia
What contributes to cancer in the GI tract?
FAP, lynch syndrome
- chronic inflammation
- dietary factors
What are the symptoms of bowel cancer? these normally only appear when cancer has developed?
- depends on the site of the lesion
- PR bleed
- altered bowel habit
- iron deficiency anaemia
- weight loss
- disease can be advanced at the time of the presentation
How do we screen for bowel cancer?
- in 60-75 year olds
- faecal occult blood test
- if positive refer for colonoscopy
- look for polyps
- see if adenomas or carcinomas
- refer for definitive treatment