What are the 2 broad categories of GI disease?
What is the difference between structural and functional GI disease?
Structural has detectable pathology whereas functional does not
What are examples of functional GI disorders?
Non-ulcer dyspepsia (NUD)
Irritable bowel syndrome
Slow transit constipation
Drug related effects
What does NUD stand for?
What do functional GI disorders have a large impact on?
Quality of life
What are functional GI disorders not associated with that structural disorders are?
What is non-ulcer dyspepsia?
Chronic or recurrent abdominal pain or nausea, without an ulcer
What is the helicobacter pylori status of non-ulcer dyspepsia?
What diseases i non-ulcer dyspepsia probably a combination of?
Low grade duodenal ulceration
Delayed gastric emptying
Irritable bowel syndrome
What does the diagnosis of non-ulcer dyspepsia involve?
Careful history and examination - FH is important
H Pylori status
If in doubt, endoscopy
What therapy is required for non-ulcer dyspepsia when H Pylori is positive?
What is nausea?
The sensation of feeling sick
What is retching?
Dry heaves (antrum contracts, glottis closed)
What is vomiting?
Abdominal contents expelled
What is often found in the history of nausea and vomiting immediately, 1 hour or more, 12 hours?
Immediate cause is psychogenic
1 hour or more is due to pyloric obstruction or motility disorders (diabetes, post gastrectomy)
12 hours or more is obstruction
What are some functional causes of nausea and vomiting?
Cyclical vomiting syndrome
What is psychogenic vomiting?
Vomiting without any obvious organ pathology or with a psychological aetiology
Who often suffers from psychogenic vomiting?
What often happens to psychogenic vomiting after admission?
What is irritable bowel syndrome?
Condition of the digestive system that can cause crampls, bloating, diarrhoea and constipation
What is slow transit constipation?
Reduced motility of the large intestine caused by abnormalities of the enteric nerves
How does bowel habit from person to person vary?
There is a great variation in both bowel habit and stool weight
What is the average stool weight in the UK?
What should be known about the interpretation of the word constipation?
It means different things to different people, so a better approach is to ask the patient about changes in the frequency, consistency, presence of blood or mucus from there normal
What are alarm symptoms relating to constipation?
Age >50 years
Short symptoms history
Unintentional weight loss
Family history of bowel/ovarian cancer
Recent antibiotic use
What investigations should be done for slow transit constipation?
U + E
What are different categories of the aetiology of constipation?
What are examples of systemic causes of constipation?
What are examples of neurogenic causes of constipation?
What are examples of organic causes of constipation?