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Gastrointestinal Disease, IBD, and Colorectal Cancer - Summary Notes $7.56   Add to cart

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Gastrointestinal Disease, IBD, and Colorectal Cancer - Summary Notes

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A comprehensive, yet concise summary of Gastrointestinal Diseases, IBD, Appendicitis, Colorectal Cancer and more in Medicine/ Surgery, presented in a colourful and digestible format. Includes all relevant information on the topic summarised, collated from multiple resources including lectures, tex...

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  • May 31, 2023
  • 5
  • 2022/2023
  • Summary
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G1Pathologies
Upper Gl ·
9PIs inhibit
gastric secretions including Intrinsic Factor,
so
they can... cause malabsorption/B12 Deficiency.
Referred for
Foregut Epigastrium 991s be tapered off & notabruptly stopped,
·
is
pain must
·

1




otherwise symptoms return more
severely
·

Gastro-Desophageal Reflux Disease (GORD):due stimulation.
to accumilation of


1. has reduced tone, causing squamous
oesophageal sphincter mucosa
damage from acid reflux.



Squamous epithelium infilrated by Eosinophils/Basophils and
undergoes hyperplasia.
·




and causeoesophagitis and Barret's
metaplasia.
·

can
progress
Barrett's Metaplasia metaplasia from Squamous to Specialised Columnar
-



epithelium

symptoms: Dyspepsia, Heartburn, salivation, belching, chronic cough, hoarse voice.
·




oesophageal sphincter hypotonia, oesophageal dysmotility, delayed gastric emptying.
·

Causes:1.




Complications:haematemesis, oesophageal stricture, ulceration.
·




Risk factors:repeatvomiting,
obesity, pregnancy, Hiatus
Hernia, smoking, alcohol.
·




·
Treatment: lifestyle changes, Antacids, add 991 (end in -zole, e.g. Omeprazole), H2 blocker.


Eosinophilic Jesoghagitis:
·




Eosinophil build-up oesophagus, presenting with trachealised mucosal
in
rings.

mimic GORD
OESINOPHILIC
symptoms Dysphagia.
· +




OESOPHAGITIS
associated with hypersensitivity reaction/allergy.
·




·
Barrett's Metaplasia:

GORD/Oesophagitis leads to changing of
Chronic

Squamous to Specialised Columnar epithelium
-


akin to Gastric/ Intestinal columnar epithelium.

BARRET'S METAPLASIA
Pre-malignant, into dysplasia then adenocarcinoma.
·
can
progress


·
Gastritis:Stomach inflammation

can lead to stomach ulceration, dysplasia, adenocarcinoma.
·




·
Risk Factors:H. Pylori, NSAIDS I
Alcohol.


Atrophic Gastritis to replacement
Chronic gastritis autoimmunity leading of
-

or


mucosa with fibrous or intestinal tissue. Can be
asymptomatic.

, Lower Gl
·
Referred pain for Midgut is Umbilicus.
·
Referred pain for Hindgut is
Hypogastrium. IBD

·

Inflammatory Bowel Disease (IBD):encompasses UC and hy's.

CROHN'S
Both
genetic autoimmune
·


responses.
only mitigate symptoms.
·
No cure, can



·
Crohn's Disease:


mostly affects ileo -cecal junction,
·




but can affectanywhere in G1 in skip lesions, whole wall thickness.
·
Character:
thickening wall
of (smaller lumen), cobblestoning of mucosa, strictures possible,
deep ulceration, fatwrapping, granulomas present, smoking increases risk.
IBD
Complications:Obstruction, perforation, strictures,
·




Fistula, malabsorption/anaemia, Arthritis.



symptoms:Diarrhoea, fever, Haematochezia, clubbing,
·




weightloss, fatigue, abdo gain, oral ulcers.

Treatment:same UC, but without ASAs for maintenance.
·

as



·Ulcerative Collitis:


affects Rectum/Descending
superficially, only mucosa.
Colon
·




Character:
haemorrhagic mucosa, surviving mucosa presentas pseudo-polyps, strictures,
·

no


larger lumen, granulomas absent, smoking reduces risk.
·


Symptoms:episodic/chronic Diarrhoea, fever, Haematochezia, clubbing.

Complications:adenocarcinoma, Arthritis/Ankylosing Spondylitis, Toxic Megacolon, Diff, PSC.
·

C.



mild/severe
Treatment:treat differently, escalate if notresponding. Goal is to induce remission.
·
IBDincreases risk Thrombosis in Acute scenario,
of
always give thromboprophylaxis.
so

Maintenance Therapy: oral/enema ASAH-Azathioprine immunosupp. HInfliximab antibody.
·




no steroids
long-term
Aminosalicylates (ASAs): Differentials/Investigations:
e.g. mesalazine.
Acute Therapy: Differentiating IBD and IBS: Faecal Calprotectin and CRP
· ·




-




Oral Prednisalone steroid. are raised during Glinflammation, suggesting IBD over IBS.

Hydrocortisone steroid.
IV
-




-Oral Infliximab antibody. Infections Colitis symptoms of colitis due to
· -




Colon Resection it infection from contaminated food, commonly after travel.
-




responding.
not commonly caused by Shigella, Salmonella, E. Coli.
Do stool culture to rule in/out
infections colitis.
AVOID ANTI-DIARRHOEA DRUGS

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