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15 Cards in this Set
- Front
- Back
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Problems of PROXIMAL Small Bowel Malabsorption
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1. Celiac Disease
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CELIAC DISEASE
pathogenesis |
Immune Mediated Sensitivity to Gluten-->Infiltration of SI Mucosa with lymphocytes-->destruction/atrophy of SI Mucosa = villous atrophy + crypt hypertrophy --> BB enz decrease --> Food Intolerance, malabsorption of Fe and other vitamins
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CELIAC DISEASE
Typical Lab Results |
Fe Def Anemia
Normal Cell Counts Endoscopy - Scalloped mucosa |
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CELIAC DISEASE
Take home factoids |
Fe Def Anemia
Calcium Malabsorption from diarrhea Proximal Myopathy from Ca and Vit D Mal Peripheral Neuropathy via Vit Mal |
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CELIAC DISEASE
Sx |
Neuro Sx's
Loss of Wt Bone Disease (osteomalacia) Osmotic Diarrhea Abd Bloating Anemia Bleeding disorders Sx's with intro of solids |
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CELIAC DISEASE
Associations |
1. Dermatitis herpetiformis
2. Cryoglobulinemia 3. IDDM (diabetes) 4. Hyposplenism 5. Selective IgA def |
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CELIAC DISEASE
Complications |
1. GI Malignancy (NHL)
2. Cryoglobulinemia 3. Ulcerative Jejunitis 4. Refractory Disease 5. Vit Def, Fracturs, Growth Retardation |
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CELIAC DISEASE
Management |
1. Gluten Free Diet
2. Avoid Lactose too 3. No beer :-( 4. Treat associated problems (e.g. skin) |
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Problems of DISTAL SI Malabsorption
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CROHN'S
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CROHN'S DISEASE
Associated Sx's |
B12 Deficiency
Megaloblastic Anemia Diarrhea |
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CROHN's Disease
Test Results |
Ulcerated Ileal Mucosa
Narrowed SI Caliber SI Bleeding |
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Crohn's
Most likely cause of diarrhea? |
Malabsorption of Bile Salts, but if enough of the ileum is shot, then fat malabsorption too
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CROHN's
progressive symptoms |
Hypercalcemia
Fractures |
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What is Cholestyramine?
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Its a bile acid sequestrant, which binds the bile salts and prevents reabsorption. It also causes the bile salts to be osmotically inactive which decreases diarrhea associated with Crohn's.
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How much SI must be removed to get fat absorption issues?
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>100cm
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