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Flashcards in Lower GI disease Deck (11)
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Functions of lower GI tract

most of digestion and absorption already done
absorbs water and electrolytes from solid stool


Acute appendicitis (inflammation)

inflammation of the appendix
obstruction by stool, stone, tumour or worms causing increased pressure and bacterial invasion
symptoms: pain (umbilical and R lower abdomen), nausea and vomiting, decreased appetite
signs: tenderness and guarding, fever, increased WBC
Treatment = open/laparoscopic surgery or antibiotics


Inflammatory Bowel Disease (inflammation)

chronic inflammatory condition - Crohn's disease and Ulcerative Colitis
idiopathic (cause unknown)
difference in signs and symptoms, pathology, treatment, and response to treatment


Crohn's disease

Affected area = lower small intestine, can be anywhere in GI tract
Pattern = spreads unevenly, inflamed areas between normal areas
Morphology = ulcerative at all layers, thickened wall, fistulae's, fissures
Symptoms = abdo pain, weight loss, nausea and vomiting
Complications = fistulae's, anaemia, malabsorption of fat and vitamins, skin, eye and joint involvement


Ulcerative Colitis

Affected area = mostly rectum and colon
Pattern = spreads continuously from the rectum
Morphology = ulceration of first layer of bowel, dilated bowel
Symptoms = diarrhoea with blood and mucus
Risk of cancer = higher than Crohn's
Complications = blood loss, electrolyte disturbance, toxic dilation of bowel, skin, eye, joint and liver involvement


Treatment of IBD

- steroids
- amino salicylates
- imunosuppressants
- biological agents
- colectomy/ resection +/- stoma formation (ileostomy)
- strictureplasty


Clostridium difficile (infection)

found in the gut, usually harmless, kept in control by other bacteria
some antibiotics change balance of bacteria in the gut = c.diff multiplies, toxins cause illness = diarrhoea, pain, fever
survives as spores for long periods of time on surfaces etc
-diarrhoea causes dehydration and spread to others
- toxic megacolon
- bowel perforation
- sepsis and death


Management of c.diff

Gloves and apron
Hand washing
Stop causative antibiotics
Start antibiotics for c.diff infection (vancomycin)
Daily assessment of stool type


Bowel cancer

4th most common cancer
risk factors include age, family history, inherited conditions, benign polyps, IBD
> National Bowel Cancer screening programme
- 60-75 - faecal occult blood test
- positive = colonoscopy to look for polyps/cancer
- refer for treatment


Signs and symptoms of bowel cancer

blood from back passage
change in normal bowel habit - diarrhoea/constipation
iron deficiency anaemia - blood loss
weight loss
abdo pain
bowel obstruction


Colon cancer

> endoscopy - colonoscopy, sigmoidoscopy = biopsy
> histology
> radiology (CT scan)
surgery = open or laparoscopic, colectomy +/- stoma formation