SAVED
File name .JPG
File alt. text
Image should be px wide x px tall.
Select Image
home - Small Bowel - Miscellaneous - Types Of Small Bowel Pathology Written by Dr Sebastian Zeki
Knowledge


Defines the pathophysiology of fluid and nutrient malabsorption,
including causes, e.g. anatomical and functional short bowel
syndrome, high output stomas, enterocutaneous fistulae and
pancreatic insufficiency

Knows how to investigate patients with malabsorption
Describes the clinical consequences of malabsorption, including
malnutrition, fluid and electrolyte disturbance and micronutrient
deficiency and anaemia and how to manage these

Describes all other causes of anaemia, including bone marrow
disorders and haemolysis

Describes the metabolism, absorption and bioavailability of iron, B12
and folate and clinical conditions and diets associated with their
deficiency

Skills
Identifies and appropriately investigates clinical features suggestive of
malabsorption

Manages fluid, electrolyte and micronutrient disturbances associated
with short bowel syndrome or high output stomas

Uses the appropriate investigations for the different types of anaemia
Behaviours
Takes a careful clinical approach to managing patients with
malabsorption and anaemia. Explains plan of management clearly to
patients and their relatives.

Types Of Small Bowel Pathology

Hypolactasia (AR) Primary-decrease in LPH (lactase phlorizin hydrolase) Secondary: acute gastroenteritis etc.-resultsRadiation More than 45 GYU Initially diarrhoea then obstruction Carbohydrate absorption problem Sucrase, Trehalase Lymphangiectasia Primary: Milroy's Secondary: CA/RPF/TB/sarcoid/CHF/Crohn's/all cause lymphangiectasia Presentation: lymphopaenia + anergy + increase alpha-1 antitripsin in stool Eosinophilic gastritis Associated with Sharcot-leyden crystals in stool Barium: Cobble stoning Treatment: Prednisolone Abeta lipoproteinaemia AR NSAID enteropathy Complications: strictures (5 %)/intestinal bleeding/protein loss (70 %)/ ileal dysfunction/malabsorption/ulcers (10 %) Associated with Collagenous colitis Coeliac Non-coeliac atrophy G Tropical sprue Rare infection Affects the whole small bowel Due to toxigenic coliforms in small bowel Presentation: malabsorption in tropics Diagnosis: history/villus atrophy/Tetracycline response Treatment: Folic Acid + Tetracycline for four months W Bile Salt Malabsorption Can't make chylomicrons + VDLD as abnormal apoprotein B Causes: Crohn's/ileal resection/cholecystectomy/ post-infectious primary bowel acid malabsorption Diagnosis: SEHCAT Treatment: Cholecystyramin e Short bowel syndrome Intestinal helminthsEnterobiasAscariasisClonorchisStrongyloides Small Bowel Pathology LymphomaInfectionsCoeliac, Crohn's, Cancer Infections TB (of all GI SB most common Hystoplasmosis Candidiasis Clostridium Perfingens MAI, C. Botulinum Bacterial Overgrowth Written by Dr Sebastian Zeki