Notes in lower GI

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Published	09/08/2024	Diagnostics for colorectal cancer: *{{c1::Colonoscopy}} (gold standard){{c5::Barium enema}}{{c4::CT colonography}} (virtual colonoscopy){{c3::CT …
Published	09/08/2024	symptoms of {{c1::colorectal cance}}r are:Painless blood PR with a BMTenesmus“Pencil stools”Abdominal painBowel obstructionConstipationColonic pe…
Published	09/08/2024	family hx, ulcerative colitis, smoking, alcohol, hx of polyps/CRC, age >50 are risk factors for {{c1::colorectal cancer }}
Published	09/08/2024	there is no definitive dx test for {{c1::IBS }}, it is a diagnosis of {{c2::exclusion}}
Published	09/08/2024	{{c1::Diverticulum}}: a sac like projection off the colon wall
Published	09/08/2024	{{c1::Diverticulosis}}: the presence of diverticulum, benign outpouching of the colon wall, present in 50% of Americans 60+, typically in sigmoid colo…
Published	09/08/2024	{{c1::Diverticulitis}}: the acute inflammation or perforation of a diverticulum, typically associated with increased pressure in diverticulum (NOT nut…
Published	09/08/2024	symptoms of {{c1::diverticulitis}}LLQ painHematocheziaFever / chills / night sweatsN/VDiarrhea or constipation
Published	09/08/2024	Complications of {{c1::diverticulitis:}}BleedingAbscess → perforation of colonFistula (after diverticula rupture)Stricture / obstruction (typical…
Published	09/08/2024	{{c3::Acute Infectious}} Diarrhea can be {{c2::noniflammatory (viral or parasitic)}} or {{c1::inflammatory (bacterial) }}
Published	09/08/2024	{{c1::NONINFLAMMATORY acute infectious}} diarrhea: Promotes intestinal secretions{{c2::Watery}}, self-limiting, {{c2::non-bloody}}
Published	09/08/2024	{{c2::INFLAMMATORY ACUTE INFECTIOUS}} DIARRHEA:Disrupts {{c1::mucosal integrity}} → more systemic symptoms{{c3::Fever, abdominal p…
Published	09/08/2024	{{c1::Osmotic}} Diarrhea causes are {{c2::malabsorption}} problems:Celiac DiseaseLactase deficiency (Lactose intolerance)Bacterial overgrowt…
Published	09/08/2024	osmotic diarrhea: Osmotically active solute(s) that are poorly {{c1::absorbed}} in the lumen draw fluid into the {{c2::bowel}}. This ad…
Published	09/08/2024	{{c1::steatorrhea}} (osmotic): can result from any distortion of {{c2::processing}} (lipolysis or micelle formation), inefficient …
Published	09/08/2024	{{c1::osmotic}} diarrhea will generally will stop with fasting or cessation of offending item or fasting-Weight loss + malnourishment (something …
Published	09/08/2024	osmotic diarrhea may have:{{c1::High }}osmolality gap{{c1::Vitamin}} deficiency{{c1::↑}} fecal fat
Published	09/08/2024	{{c1::secretory}} diarrhea :Bile acid diarrheaNeuroendocrine tumorToxin mediated (Cholera)
Published	09/08/2024	{{c1::secratory}} diarrhea is caused by active {{c2::ion}} secretion into lumen of bowel producing a derangement of fluid or electrolyt…
Published	09/08/2024	{{c4::secretory}} diarrhea has {{c1::low}} volume, {{c1::watery}} diarrhea and generally does {{c1::NOT stop}} with…
Published	09/08/2024	secretory diarrhea will have:{{c1::Low}} osmolality gapTypically {{c1::Na and K}} are elevated{{c1::Negative}} fecal fat
Published	09/08/2024	Ulcerative colitisTreating sigmoid + rectal inflammation:PR: {{c1::5-ASA, steroids}}PO: {{c1::5-ASA, steroids}}, antibiotics, 6-MP, inflixim…
Published	09/08/2024	Ulcerative colitis If a patient fails medical therapy, has severe fulminant colitis, or is severely malnourished, then a total {{c1::proctoc…
Published	09/08/2024	Ulcerative colitis {{c1::Surgery}} is curative but carries a high risk15 years after diagnosis, the risk of {{c2::colorectal cancer}}&n…
Published	09/08/2024	diagnostics of UC: Labs:{{c1::PrealbuminC. diffStool culture}}{{c2::Colonoscopy}}: loss of vascularity, edema, friability, uniform circumferentia…
Published	09/08/2024	Uncomplicated {{c1::diverticulitis}}:Course of {{c2::dual antibiotic}} therapy (cipro + flagyl)
Published	09/08/2024	Complicated Diverticulitis:{{c1::Admit}}for IV antibiotics, monitor pt for progression of {{c2::peritonitis}}{{c3::Surgical resection}} if p…
Published	09/08/2024	{{c3::Crohn's disease}} treatment will involveLifelong battle with intermittent {{c1::flares}} and periods of {{c2::remission}}Therapy …
Published	09/08/2024	Meds used from initial presentation → advanced disease of {{c2::Crohn's disease}}{{c3::5-ASA meds (sulfasalazine, mesalamine)Antibiotics (cipro, flagy…
Published	09/08/2024	{{c2::IBS}} treatment:Management:{{c1::Lifestyle (stress), Dietary (keep diary)}}Treat symptoms first:{{c3::Constipation}}: PEG, lubiproston…
Published	09/08/2024	Polyps are to be removed by {{c1::endoscopy}} if possible in CRC
Published	09/08/2024	Cannot use {{c1::radiation}} to treat colon cancer
Published	09/08/2024	Stage {{c1::0}}: carcinoma in situ, contained in polyp
Published	09/08/2024	Stage {{c1::I}}: confined to mucosa / submucosa (surgical resection)
Published	09/08/2024	Stage {{c1::II}}: muscularis mucosa (surgical resection)
Published	09/08/2024	Stage {{c1::III}}: lymph invasion (surgical resection followed by chemotherapy)
Published	09/08/2024	Stage {{c1::IV}}: metastasis (chemotherapy followed by possible resection of metastatic disease. Fecal diversion required if concerns for obstruction)
Published	09/08/2024	Rectal cancer: {{c1::similar}} management to colon cancer except stage {{c2::III}} disease gets neoadjuvant radiation and chemo
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