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1

what is diverticular disease

when the mucosa herniates via musclaris lt a non inflammed outpouching

2

what is the clinical term for an outpouching

diverticula

3

where are diverticula most common

sigmoid colon

4

what is important to remember about GI mucosa in diverticular disease

it is all intact

5

what is the percent incidence after age 80

85%

6

et/risks of diverticular disease

ageing
diet
poor bowel habits (all leading to constipation)

7

why do outpouchings occur in diverticular disease (patho)

weak points in wall where blood vessels enter that are normally tight, loosen with age

8

what happens to intralumanal P in diverticular disease

increased, lt inc strain on GI wall lt mucosia herniating thru muscularis externa

9

2 types of diverticular disease

diverticulosis
diverticulitis

10

diverticulosis

asymptomatic out pouchings of GI tract

11

diverticulitis

inflm that is problematic

12

diverticulitis mnfts

dull aching pain, low grade fever, nausea, vomiting

13

why do diverticulitis pts have fevers

endogenous pyrogens (cytokines -> interlukin 1 and 6) are released into blood stream resulting in fever

14

tx of diverticular disease

address ET/risks
sx for obstruction or perforation

15

IBS

intestinal mobility disorder related to peristalsis with no obvious patho

16

et of IBS

unclear, but risks and triggers are related to diet, followed y smoking, stress, lactose intolerance

17

general patho of IBS

alterted CNS regulation of GI motor and sensory fx

18

what is the first speculation of patho in IBS

ingestion of fermentable cho's and polyols results in inability to digest by stomach -> content moving to LI causing normal flora to digest and create gas as a by product -> pain

19

eg of fermentable cho

fructose

20

eg of polyol

sorbitol

21

second speculation of patho in IBS

molecular signalling defect via seratonin, resulting in dysfx at the molecular lvl regarding seratonin

22

what is seratonin

NT

23

where is most seratonin produced

epithelial cells in the GI tract

24

what are the 4 normal fxs of seratonin

Motility - peristalsis
sensation - pain
secretion - mucous, H , enzymes
perfusion - dilation/constriction of vessels

25

what do problems at the molecular lvl involve

signalling, messengers

26

mnfts IBS

abdominal pain and discomfort
constipation/diarhea
mucoid stools
flatulence

27

can a pt have both constipation and diahrhea (not simultaneously)? how so?

its based on peristalsis and the trigger causing the problem.

28

what is the number one mnft/problem in ibs

constipation / diarhea / bowel habits

29

why may an ibs pt have mucoid stools

dt abn mucous sec / inc mucous sec dt seratonin dysfx

30

dx IBS

difficult to dx, work by exclusion to ensure its not an organic disease, Labs, scopes, presentation