Lower GIT

Question 1

state the anatomical components of the lower GIT

Answer 1

• small intestine: jejunum (absorbs iron) and ileum (absorbs Vitamin B12)
• large intestine colons (absorbs water and electrolytes)
• rectum and anus

Question 2

what are the symptoms of lower GI bleeding

Answer 2

• fresh blood mixed w stool

- occult blood (not visible by eye)

Question 3

how do you investigate lower GI with radiology?

Answer 3

unlike the upper GI, barium sulphate drinks aren’t effective for the lower GI as they don’t reach it, so the patient has to have a barium meal instead. another way is by barium enema which is stuck up the anus.

Question 4

how do you directly visualise the lower GI during an investigation?

Answer 4

• Endoscopy (through the mouth)
• Sigmoidoscopy: limited to lower 1/3 of the colon
• Colonoscopy: visulises the whole colon

Question 5

state the lower GI disorders

Answer 5

• coeliac disease
• inflammatory bowel disease (Crohn’s and ulcerative colitis)
• diverticular disease
• irritable bowel syndrome

Question 6

what is coeliac disease

Answer 6

an autoimmune disease that causes dietary complications. Proteins such as gluten will activate mucosal responses causing damage to the lining of the small intestine.

Question 7

what are the predisposing factors to coeliac disease

Answer 7

• autoimmune thyroid gland disease
• genetics
• type 1 diabetes

Question 8

what are the symptoms of coeliac disease?

Answer 8

• diarrhoea
• weight loss
• malabsorption

Question 9

what are the oral symptoms of coeliac disease?

Answer 9

• enamel defects

- oral ulcers

Question 10

how do you manage coeliac disease?

Answer 10

• gluten-free diet

- correct deficiencies

Question 11

what are the two inflammation bowel diseases? (IBD)

Answer 11

• Crohn’s disease (entire GI tract from mouth to anus)

- Ulcerative colitis (lare intestine)

Question 12

what are the symptoms of Crohn’s disease?

Answer 12

• abdominal pain
• malabsorption
• bleeding

Question 13

what are the symptoms of ulcerative colitis?

Answer 13

• bloody diarrhoea
• abdominal pain
• rare oral manifestations, mainly confined to the colon

Question 14

what are the oral symptoms of Crohn’s disease?

Answer 14

• full-width gingival inflammation
• ulcerations
• lip and facial swelling
• mucosal tags
• cobblestone mucosa

Question 15

what are the treatments for IBD?

Answer 15

• surgically removing the diseased bowel or draining the abscess
• antibiotics

Question 16

how do you investigate for IBD?

Answer 16

• Colonoscopy

- Radiolabelled WBC scanning

Question 17

what is irritable bowel syndrome (IBS)?

Answer 17

altered bowel habits with abdominal pain, pretty common with diarrhoea and constipation involved.

Question 18

what is the treatment for IBS?

Answer 18

• antispasmodics
• reassurance
• dirty changes

Question 19

what are the predisposing factors to IBS?

Answer 19

• diet
• genes
• drugs
• psychosocial factors
• GI inflammation/infection

Question 20

what are the dental considerations for patients with lower GI disease

Answer 20

• avoid NSAID’s for patients with IBD or IBS
• check for drug side effects on the GI tract (these side effects include one marrow suppression and increased risk of infection)
• check for drug interactoins