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Questions and Answers
What condition is NOT associated with dysphagia?
What condition is NOT associated with dysphagia?
Which of the following is a cause of oropharyngeal dysphagia?
Which of the following is a cause of oropharyngeal dysphagia?
What is a potential complication of dysphagia?
What is a potential complication of dysphagia?
Which condition involves altered peristalsis, contributing to oesophageal dysphagia?
Which condition involves altered peristalsis, contributing to oesophageal dysphagia?
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What is commonly associated with globus syndrome?
What is commonly associated with globus syndrome?
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What anatomical feature is involved in a hiatus hernia?
What anatomical feature is involved in a hiatus hernia?
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Which factor contributes to anaesthesia risk during surgery for patients with dysphagia?
Which factor contributes to anaesthesia risk during surgery for patients with dysphagia?
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Which of these statements is true about physical obstructions causing dysphagia?
Which of these statements is true about physical obstructions causing dysphagia?
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Which part of the gastrointestinal tract is primarily responsible for the entrance of pancreatic enzymes and bile salts?
Which part of the gastrointestinal tract is primarily responsible for the entrance of pancreatic enzymes and bile salts?
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What condition is characterized by difficulty swallowing food or liquid?
What condition is characterized by difficulty swallowing food or liquid?
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Which of the following gastrointestinal diseases is associated with the lack of intrinsic factor?
Which of the following gastrointestinal diseases is associated with the lack of intrinsic factor?
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What is the main function of the large bowel?
What is the main function of the large bowel?
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Which gastrointestinal disorder involves inflammation leading to symptoms such as abdominal pain and bloody diarrhea?
Which gastrointestinal disorder involves inflammation leading to symptoms such as abdominal pain and bloody diarrhea?
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What is a common complication of long-standing oral dryness?
What is a common complication of long-standing oral dryness?
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Which part of the gastrointestinal tract is the major site for the absorption of vitamin B12?
Which part of the gastrointestinal tract is the major site for the absorption of vitamin B12?
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Which disorder is characterized by excessive acid generation and may lead to gastric erosion or ulceration?
Which disorder is characterized by excessive acid generation and may lead to gastric erosion or ulceration?
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What condition results from gluten sensitivity and can lead to malabsorption of nutrients?
What condition results from gluten sensitivity and can lead to malabsorption of nutrients?
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Which section of the gastrointestinal tract primarily facilitates water absorption?
Which section of the gastrointestinal tract primarily facilitates water absorption?
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What is a possible implication of oesophagitis related to posture?
What is a possible implication of oesophagitis related to posture?
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Which factor is NOT a risk factor for upper gastrointestinal erosion?
Which factor is NOT a risk factor for upper gastrointestinal erosion?
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What symptom is least likely to occur due to gastrointestinal conditions mentioned?
What symptom is least likely to occur due to gastrointestinal conditions mentioned?
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What type of dental erosion is associated with gastro-oesophageal reflux?
What type of dental erosion is associated with gastro-oesophageal reflux?
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Which of these conditions is most likely to cause malabsorption?
Which of these conditions is most likely to cause malabsorption?
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What is a common symptom of upper gastrointestinal erosion?
What is a common symptom of upper gastrointestinal erosion?
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Omeprazole is associated with which side effect?
Omeprazole is associated with which side effect?
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What type of anemia can result from inflammation in individuals with inflammatory bowel disease?
What type of anemia can result from inflammation in individuals with inflammatory bowel disease?
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Which oral condition is associated with Crohn’s disease?
Which oral condition is associated with Crohn’s disease?
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What is a potential risk associated with continuous NSAID use in patients with gastrointestinal issues?
What is a potential risk associated with continuous NSAID use in patients with gastrointestinal issues?
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What does the term 'malabsorption' describe?
What does the term 'malabsorption' describe?
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What symptom is representative of irritable bowel syndrome?
What symptom is representative of irritable bowel syndrome?
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Which condition is least likely to contribute to gastrointestinal discomfort?
Which condition is least likely to contribute to gastrointestinal discomfort?
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What is a significant risk factor for colorectal carcinoma?
What is a significant risk factor for colorectal carcinoma?
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Which statement is true regarding the oral manifestations of anorexia nervosa and bulimia nervosa?
Which statement is true regarding the oral manifestations of anorexia nervosa and bulimia nervosa?
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Which systemic condition may lead to possible access issues related to severe disease?
Which systemic condition may lead to possible access issues related to severe disease?
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What potential oral issue is associated with corticosteroid use in patients with inflammatory bowel disease?
What potential oral issue is associated with corticosteroid use in patients with inflammatory bowel disease?
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In patients with inflammatory bowel disease, which of the following risks are present?
In patients with inflammatory bowel disease, which of the following risks are present?
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What is a common complication of gastrointestinal disease that can impact oral health care?
What is a common complication of gastrointestinal disease that can impact oral health care?
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Which of the following conditions is associated with disordered eating patterns?
Which of the following conditions is associated with disordered eating patterns?
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How may energy drink overuse affect dental health?
How may energy drink overuse affect dental health?
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What is a significant risk when administering general anesthesia to a patient with gastrointestinal disease?
What is a significant risk when administering general anesthesia to a patient with gastrointestinal disease?
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Patients with enamel hypocalcification secondary to gluten sensitive enteropathy face an increased risk of which dental issue?
Patients with enamel hypocalcification secondary to gluten sensitive enteropathy face an increased risk of which dental issue?
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Which of the following statements about drug interactions is true for patients with chronic gastrointestinal disease?
Which of the following statements about drug interactions is true for patients with chronic gastrointestinal disease?
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What should be considered when managing patients who have long-term corticosteroid use for inflammatory bowel disease?
What should be considered when managing patients who have long-term corticosteroid use for inflammatory bowel disease?
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What orofacial manifestation may occur with some gastrointestinal disorders?
What orofacial manifestation may occur with some gastrointestinal disorders?
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What is a complication associated with gluten sensitive enteropathy?
What is a complication associated with gluten sensitive enteropathy?
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Which condition is a common cause of malabsorption leading to anaemia?
Which condition is a common cause of malabsorption leading to anaemia?
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Which best describes the inflammation seen in Crohn's disease?
Which best describes the inflammation seen in Crohn's disease?
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Which statement is true regarding pancreatic cancer?
Which statement is true regarding pancreatic cancer?
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What is the implication of vitamin K deficiency in malabsorption disorders?
What is the implication of vitamin K deficiency in malabsorption disorders?
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Which gastrointestinal disorder is characterized by granulomatous inflammation?
Which gastrointestinal disorder is characterized by granulomatous inflammation?
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What is a possible oral complication of gluten sensitive enteropathy?
What is a possible oral complication of gluten sensitive enteropathy?
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Which symptom is NOT typically associated with chronic pancreatitis?
Which symptom is NOT typically associated with chronic pancreatitis?
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What is the characteristic involvement of ulcerative colitis?
What is the characteristic involvement of ulcerative colitis?
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What is a potential risk associated with dapsone-treated dermatitis herpetiformis?
What is a potential risk associated with dapsone-treated dermatitis herpetiformis?
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Study Notes
Course Information
- Course code: BDS13048
- Course title: Gastrointestinal and hepatic disease I
- Aim: To describe the potential impact of gastrointestinal or hepatic disease upon oral health and oral health care (dentistry)
- Intended learning objectives: On completion of this lecture, students should understand:
- Oral diseases that may arise in patients with gastrointestinal or hepatic diseases
- Impact of gastrointestinal or hepatic disease on the delivery of oral health care
Gastrointestinal Tract
- Anatomy: Includes the oesophagus, stomach, small bowel (duodenum, jejunum, ileum), large bowel (rectum), and anus
- Function:
- Oesophagus: Passage to stomach
- Stomach: Acid generation, intrinsic factor generation, physical breakdown of food
- Small bowel: Initial food breakdown, pancreatic enzyme and bile salt entry (fat absorption), breakdown, and major site for absorption (specifically jejunum for breakdown and absorption, ileum for absorption of vitamin B12). The duodenum is the initial site.
- Large bowel: Water absorption
- Rectum: Faecal storage
Gastrointestinal Tract: Disorders
- Small bowel: Gluten sensitive enteropathy (coeliac disease), pancreatic disease, and malignancy
- Anus: Haemorrhoids
- Stomach: Gastro-oesophageal reflux/hiatus hernia, gastric erosion/ulceration, autoimmune destruction of parietal cells (intrinsic factor deficiency and pernicious anaemia), malignancy
- Large bowel: Inflammatory bowel disease (Crohn's disease and ulcerative colitis), malignancy
- Rectum: Malignancy
- Oesophagus: Dysphagia
Dysphagia - Difficulty Swallowing
- Causes: Oral problems (dryness, disease of the tongue or soft palate structure), Pharyngeal issues (painful disease, pharyngeal pouch, malignancy, loss of motor function), Oesophageal issues (physical obstructions, altered peristalsis)
- Implications: Aspiration risk (upright positioning, high velocity suction, rubber dam, lighting), anaemia risk, inability to swallow medication, globus syndrome
Hiatus Hernia and Oesophagitis
- Hiatus hernia: Part of the stomach herniates through the diaphragm
- Oesophagitis/GERD: Reflux of gastric acid, pain radiating to the back, worse on stooping
- Implications: Pain in supine position, anaemia risk, inability to swallow medication
Upper Gastrointestinal Erosion/Ulceration
- Causes: Stress, smoking, NSAIDs, corticosteroids, H. pylori infection, Zollinger-Ellison syndrome
- Implications: Anaemia risk, difficulty swallowing medication, worsened by NSAIDs, worsened by systemic corticosteroids
Small Bowel Disease ("Malabsorption")
- Malabsorption: Occurs when there is disease of the small bowel (especially the jejunum and ileum)
- Features: Abdominal pain, diarrhoea, fatty stools, vitamin deficiencies (e.g., K, leading to bleeding tendency), hypocalcaemia
- Causes: Gluten sensitive enteropathy (Coeliac disease), Post-gastrectomy, Post-vagotomy, Chronic pancreatitis, Others
- Implications: Anaemia, delayed eruption, enamel defects, possible oral ulcers, ulcers/blisters, possible risk of methaemoglobinaemia
Chronic Pancreatitis
- Causes: Alcohol-induced, idiopathic, cystic fibrosis
- Features: Epigastric pain, anorexia, weight loss, steatorrhoea, diabetes
- Implications: Alcohol misuse, malabsorption, anaemia, bleeding tendency, diabetes, possible risk of post-surgical malabsorption
Pancreatic Cancer
- Risk factors: Tobacco, alcohol
- Features: Poor outcome, especially in non-head lesions
- Implications: Malabsorption, anaemia, bleeding tendency, diabetes
Inflammatory Bowel Disease
- Inflammation of the bowel
- Most commonly observed in ages 20-45
- Combined prevalence 1 in 10,000
- Crohn's disease and ulcerative colitis
- Implications: (Crohn's) Granulomatous inflammation, Inflammation affects all layers of the gut, possible skip lesions, abdo pain (lower right), altered bowel habits, fistula formation (peri-anal), risk of abscess formation, iron deficiency anaemia, and/or B12 if at the terminal ileum
- Implications: (Ulcerative colitis) Non-granulomatous inflammation, inflammation of the mucosa of the entire colon, especially rectum, clinical picture akin to that of Crohn's but reduced risk of fistulae and abcesses, risk of colonic adenocarcinoma with long-standing total colonic UC
- Implications (for both Crohn's and Ulcerative colitis): Possible anaemia (Fe, B12), Corticosteroids, Immunosuppression, Oral swellings, superficial ulceration and pustule formation (pyostomatitis vegetans), Possible corticosteroid-associated thrush, Possible immunosuppression-related oral hairy leukoplakia (OHL) Access limitations if disease is severe
- Implications: Anaemia, Corticosteroids, Immunosuppression?
Irritable Bowel Syndrome
- Common in adults (20%+ of the population)
- Features: Altered bowel habits (loose or "rabbit-dropping" stools), bloating, colic (pain in right iliac fossa with relief on defecation), morning rush defecation
- Implications: Possible TMJ dysfunction or idiopathic facial/oral pain
Colorectal Carcinoma
- Almost always adenocarcinoma
- Causative factors: High animal fat, low-fiber diet, longstanding ulcerative colitis
- Features: Altered bowel habits, rectal bleeding, weight loss, tenesmus, anaemia
- Implications: Anaemia, access issues (post-surgical colostomy)
- Implications may include association with Gardner's syndrome
Eating Disorders
- Anorexia nervosa and bulimia nervosa
- Predominantly younger adult females with avoidance and binge-purge behaviours
- Reduced food and calorie intake
- Implications: Anaemia risk, Oral manifestations (Erosion, haematinic deficiency oral ulcers, necrotising sialometaplasia, sialosis (bilateral painless salivary gland enlargement))
Implications of Gastrointestinal Disease - Summary
- Access to care: Affected by malignancies and inflammatory bowel disease
- Communication: Affected by chronic pancreatitis
- Consent: Affected by chronic pancreatitis
- Education: Importance of patient awareness regarding gluten sensitivity and enamel hypocalcification (increased risk of caries if gluten sensitive enteropathy)
- Surgical Issues: Anaesthesia issues (risk with severe bleeding tendency), prescriptions with NSAIDs and systemic corticosteroids, orofacial issues/manifestations/features
- Spread: No direct risk
Gastrointestinal and Hepatic Disease - Key Points
- Anaemia is a major complication of gastrointestinal issues and potentially impacting oral health, primarily when general anaesthetic is required
- Bleeding tendencies and altered drug metabolism can cause complications when managing patients with chronic liver disease
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Description
Test your knowledge on dysphagia and related gastrointestinal disorders with this quiz. Explore conditions, complications, and anatomical features associated with swallowing difficulties as well as the main functions of various parts of the gastrointestinal tract. Ideal for students and professionals in the medical field.
