Digestive System Disorders Trivia

1. Diverticulosis is a condition which occurs in what bodily organ?

From Quiz Diverticulosis? Huh?

Answer: Large intestine

Diverticulosis is caused by leftover undigested material in the large intestine. Most people are not even aware that they have this condition as it causes no discomfort in the majority of those with it.

From Quiz Crohn's Disease

Answer: Any part of the gastrointestinal tract

Crohn's Disease is an inflammatory bowel disease that can affect any part of the body's GI tract, from the mouth to the anus.

From Quiz Inflammatory Bowel Disease

Answer: Auto-immunity

Although these can all cause bowel problems with similar symptoms, the main categories of IBD are auto-immune where the antibodies or similar mechanisms attack the intestines in one way or another. It is mainly genetic, with twin studies showing a high correlation, and has so far been linked with 32 different genetic mutations as the main underlying cause of the auto-immune reaction. It can further be aggravated by environmental causes, including smoking and previous infection (Mycobacterium avium subspecies paratuberculosis [MAP] has been found to spark a faulty immune response which becomes IBD for example). Other factors such as diet and stress are commonly found to aggravate most existing conditions. It is not directly caused by cancer but can become cancerous if severe.

From Quiz Diverticulosis? Huh?

Answer: Spherical pouches

The leftover residue in the large intestine presses against the wall of the large intestine making small pouches or pockets where the residue sits. These pouches are called diverticulae.

From Quiz Crohn's Disease

Answer: Abdominal pain, diarrhea, vomiting and weight loss

Crohn's Disease can also cause anemia, vitamin deficiencies, arthritis and certain disorders of the eye.

From Quiz Inflammatory Bowel Disease

Answer: Crohn's disease and ulcerative colitis

Although they have very similar symptoms, ulcerative colitis (UC) and Crohn's disease are different and make up the great majority of IBDs. There are various other forms of chronic colitis, which can be caused by restricted blood supply (ischaemia), an abnormal increase in lymphocytes, Behcet's disease, which affects all mucosa outside the colon, and when not possible to be certain, indeterminate colitis. Diverticulitis is caused by weakness in the intestinal wall causing the formation of pouches which become infected, while enteritis involves any part of the intestine and normally describes an acute and temporary infection. Irritable bowel syndrome imitates milder symptoms of IBD but is not found to be inflammatory and is still unknown in cause and little better in treatment.

From Quiz Diverticulosis? Huh?

Answer: CAT scan

Though the other three tests can give additional information about the person's condition, diverticulosis can only be diagnosed by a CAT scan, combined with any of a colonoscopy, surgery and barium xrays.

From Quiz Inflammatory Bowel Disease

Answer: Location

Unlike ulcerative colitis (the clue is in the name), Crohn's disease usually starts in the terminal ileum and is not restricted to the colon and rectum but can spread to the entire alimentary tract from the mouth to the anus. The damage itself is also different, as ulcerative colitis only reaches the gut's epithelial lining, while Crohn's disease can penetrate the entire gut. Crohn's appears in patches while UC involves contiguous areas of damage. There is a fairly long table used by the medical profession to distinguish the two. But in initial presentation the common symptoms of chronic flare-ups of diarrhea, intestinal pain, possible vomiting and weight loss make it hard to tell exactly what is causing it before tests. The causes are both generally known (discussed elsewhere in the quiz) and similar, and although can develop more in people over 65, age is not a distinguishing factor.

From Quiz Gastrointestinal Bleeding

Answer: peptic ulcers

About fifty percent of the cases of upper gastrointestinal bleeding are due to peptic ulcer disease (PUD). Although gastric juice has a pH of about 1.5, several mechanisms come into play to keep the pH of the gastric and duodenal mucosa higher than 6. If for some reason, these protective mechanisms are destroyed, the stomach or duodenal lining becomes exposed to gastric juices and auto-digestion takes place. When underlying blood vessels are eroded, bleeding occurs. The factors which predispose to PUD include excessive use of alcohol, smoking, infection with helicobacter pylori, use of non-steroidal anti-inflammatory drugs and stress caused by severe illness. Since so many factors predispose to these ulcers, PUD is the most common cause of UGIB.

From Quiz Diverticulosis? Huh?

Answer: Colonoscopy

The colonoscopy is a procedure where a camera is inserted into the intestine through the rectum which allow the doctors to see up close what is going on inside. It is not used in the initial diagnosis because the doctors don't want to irritate the infection. The colonoscopy can also pick up other issues which may be present in the large intestine. A stool test can help determine if there is blood in the stool but not the cause. Phasers are a Star Trek weapon that shoot energy beams at different strengths. Let me know if you ever see one.

From Quiz Crohn's Disease

Answer: A combination of tests

There is no one definitive tool used to diagnose Crohn's Disease. A colonoscopy is most successful, but can still miss up to 30% of Crohn's cases. Blood work can show inflammation in the body and vitamin deficiencies that are common in Crohn's. Imaging such as x-rays, MRIs and endoscopies can show areas of inflammation that a colonoscopy can't see.

From Quiz Diverticulosis? Huh?

Answer: Diverticulitis

-Itis is often the suffix of an infection. So, when the diverticulae become infected, diverticulosis changes to diverticulitis. This is when the symptoms start to appear - pain, fever, etc.

From Quiz Inflammatory Bowel Disease

Answer: Anti-inflammatories

Since IBD is an inflammatory disease, steroids and similar anti-inflammatory drugs are the main treatment, especially for long term use, although they are almost guaranteed to cause side effects such as weight gain, Cushing's syndrome and osteoporosis. Antibiotics should not be used as there is no infection involved unless there is a complication, in which case would only be used for that specific instance. Diet is another treatment as often certain foods can be discovered to increase the inflammation and tests can be carried out for sensitivity. Exercise is usually beneficial but only for general fitness and within the scope of the individual patient. Since the disease is auto immune, immunosuppressants are also commonly used but carry their own risks as you would expect from a lowered overall immune system.

From Quiz Gastrointestinal Bleeding

Answer: upper

When discussing GI bleeding with your doctor, it's important to note the color of stools since this gives a rough idea regarding the site of origin of the bleed. When bleeding occurs in the stomach and upper portions of the small intestine, the iron in the hemoglobin becomes oxidized due to chemical reaction between the blood and digestive enzymes. This causes the stool to be black, foul smelling and pasty in consistency. Bleeding from the lower GI tract is usually red or maroon in color because the distance to the anus is shorter allowing for less contact with digestive enzymes. It should be noted however that massive bleeding hastens peristaltic activity so the transit time is much shorter. For this reason, a person with severe upper GI bleeding may actually have red instead of black stools.

From Quiz Diverticulosis? Huh?

Answer: Overweight and people with low-fiber diets

There are other factors which come into play to create this condition. There used to be a large statistical difference between genders when males were the predominant sufferers of this ailment. In the years 2000-2007 the gap between genders closed slightly. Other research has also shown that in older people, the disease tends to affect more women than men.

From Quiz Inflammatory Bowel Disease

Answer: Colonoscopy

Faecal tests are usually used as the first step in eliminating certain alternatives, but once suspected direct inspection of the intestinal inner lining by colonoscopy is by far the most revealing way to discover IBD or whatever else is causing the symptoms, most notably diarrhoea. Ulcers, their extent and severity, and any other different causes such as diverticuli (pouches like small hernias) or tumours are all visually detectable directly. Blood tests are also useful also in detecting other causes such as infections and parasites. A biopsy may also be taken during the colonoscopy especially to see if any lesion is cancerous.

From Quiz Piles of Information

Answer: Gangrene

Like hernias, piles can become twisted, and if the blood supply becomes cut off the protruding tissue will soon die and become gangrenous, which must be removed as soon as possible before it spreads. This is called 'incarceration'. Incontinence is only possible by slight leakage in bad cases. Infection is possible and also needs immediate treatment, but will not be likely to cause any lasting damage or automatically need surgery. Internal piles can get in the way but will not be large enough to prevent normal function and passage.

From Quiz Crohn's Disease

Answer: Surgery

In its most serious form, Crohn's Disease may require patients to undergo multiple surgeries in order to remove diseased portions of the intestine. This is not a cure, however, and often the disease reappears in different parts of the GI tract.

From Quiz Inflammatory Bowel Disease

Answer: Surgery

If other treatment is not effective eventually the bowel becomes so damaged it is not possible to recover and has to be cut out entirely. A colostomy is usually put in place to allow the bowel to heal without being used for about six months, but if the amount removed is too great this may have to be permanent. But this is a result of the surgery and not a treatment in itself. The damaged bowel needs to be removed entirely, while a colostomy alone would simply bypass the bowel without preventing any further damage. New treatments and research are constantly being investigated so it may be possible to reduce the number of cases which go far enough to require surgery in future.

From Quiz Gastrointestinal Bleeding

Answer: esophageal varices

The most common cause of esophageal varices is cirrhosis of the liver. When there's chronic liver disease, scarring of the liver tissue takes place. This interferes with proper flow of blood through the liver. The blood vessels which empty blood into the liver either directly or indirectly become backed up with blood. For this reason, the veins in the lower esophagus become engorged with blood and can rupture easily. Once diagnosed, usually through EGD, necessary steps can be taken to prevent rupture of the varices.

From Quiz Piles of Information

Answer: Where they originate

Although piles can be found inside or outside the rectum, it is not whether they protrude or not that defines their type but where they grow. External piles form on the anal cushion where they remain, while internal piles form on the rectal wall and if large enough can protrude through the anus (prolapse). First degree piles are internal and bleed, second are prolapsed but can retract on their own, third prolapse but can be pushed back, and fourth are prolapsed but cannot be pushed back.

From Quiz Diverticulosis? Huh?

Answer: It is individual

In a forum for sufferers, the discussion on diet highlights that people's reactions to food is so varied that they need to be aware of how food affects them individually. Doctors have written conflicting opinions and produced conflicting research as to what is the best diet to follow. "Cura te ipsum" - patient heal thyself. Get the information from your doctor and, as one gastroenterologist said, "Learn what the best diet for YOU is." A liquid or low-residue diet is suggested when the pockets become infected and the condition changes to diverticulitis.

From Quiz Crohn's Disease

Answer: An auto-immune reaction

Crohn's Disease occurs when the body's immune system attacks healthy cells in the digestive tract, causing inflammation and pain.

From Quiz Crohn's Disease

Answer: Acupuncture

Acupuncture is widely used in Asia as a treatment for Crohn's Disease. It is starting to become more popular in the US, along with other treatments.

From Quiz Piles of Information

Answer: Diet

Although heredity plays a large part in who suffers from piles, those caused by chronic straining on hard stools can be prevented by adding more fibre to the diet. Soft fruit in particular is a good and very healthy way to prevent this happening and far better than laxatives and other medical treatments. Not having children will certainly prevent piles caused by pregnancy and childbirth, but does not affect all women and is far too high a cost to avoid a relatively minor problem.

From Quiz Diverticulosis? Huh?

Answer: 18-19th century CE

It is a relatively recent discovery that this condition exists. It may have existed earlier but was not diagnosed. The existence of these pouches was described in the late 18th century and knowledge of this situation was expanded upon through the 19-20th centuries. There is continuing research on the diagnosis and treatment of this condition.

From Quiz Crohn's Disease

Answer: Adolescence through early adulthood

Crohn's Disease is most often diagnosed in 15-30 year olds, with a second peak among those over the age of 70.

From Quiz Inflammatory Bowel Disease

Answer: Bacteria

Although many auto-immune diseases like lupus and arthritis attack healthy tissue, Crohn's disease is thought to be caused by a release of TNF (tumour necrosis factor) in the bowel and alimentary canal which kills all bacteria including the ones we need for digestion. The direct and indirect effects (from the lack of required bacteria) cause the damage to the gut lining and in severe cases work their way through, causing perforation which requires immediate surgery. The mucosa is affected by Behcet's disease, which also extends beyond the colon to the entire body wherever it can be found.

From Quiz Piles of Information

Answer: Witch Hazel

Sometimes the old ways are the best. Witch Hazel was found to be more effective than proprietary creams and lotions in shrinking the size of piles, and the second most effective was hydrocortisone, a man made anti-inflammatory which is in some creams. Other methods are more likely to work on pain and itching without having much effect on the actual size of the associated protrusions and swellings.

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