GIT medicineL2

Investigations in GIT Diseases: Dr Monem Alshok 16 / 10 / 2016
GIT diseases are the Major cause of morbidity & mortality.
10% of GP consultations are for indigestion.
¼ of GP consultations for diarrhea.
Infective diarrhea is a major cause of ill heath & death in developing countries.
GIT is one of the most common sites for cancer.
Major advances had occurred in the field of GE;
PUD proved to be an infective condition due to HP & Nobel prize had been given recently to its discoverer, Marshal.
Molecular events in the CRC development had been discovered & from this effort became successful in its prevention by NSAIDs.
GIT endoscopy made diagnosis of GIT diseases very easy.
Therapeutic endoscopy made it possible to replace surgery for many GIT conditions as GI bleeding, bilairy stone removal & stenting, palliative cancer stenting, polyp removal, PEG & endoscopic mucosal resection.

In order to reach a diagnosis for digestive disorders,
1 . Thorough and accurate medical history will be taken by physician , noting the symptoms you have experienced and any other pertinent information.
2 . A physical exam is also done to help assess the problem more completely.
3 . Investigations

The diagnostic tests can be divided into several categories:
Structural tests
Functional tests
Microbiology & Tests for Helicobacter pylori
Special blood tests( Serology , Chemistry )
Special stool tests
Histopathology tests

1. Blood tests :
( Types of Anemia ,leucocytes , platelets, blood film , )
2.PT( Prothrombine Time ) malabsorption of Vit K
3.Acute phase markers ( ESR , C reactive protein ) and plasma viscosity .
4. Biochemistry ( B urea , Electrolytes ,Proteins ) LFTs( Liver Function tests )
5.Endoscopy ( OGD , Colonoscopy , ERCP , Enteroscopy , )
Therapeutic & Diagnostic
6. Radiology :
Plain Radiography , Contrast studies ( Ba swallow , Ba meal , Ba follow through and small bowel enema , Ba enema ) ,
7. GIT Angiogrophy
8. U\S , CT , MRI & MRCP , CT-PT scan
9. Radio isotopes study
10. Functional Tests :
Oesophageal :
*pH testing
*Manometry
*Bernstein test
Small intestine : Tests for Malabsorption
1. Stool Analysis ( Fecal Fat )& steatorrhea
2. 14C – triolein Breath test
4. Pancreatic Function Tests ( Pancreolauryl test for pancreatic fat digestion )
5. Carbohydrates ( D – Xylose test , GTT , Lactose Tolerance test )
6. Hydrogen Breath test for bacterial overgrowth
7. Coeliac Serology
8.Stool Analysis & culture
9. Schilling test, ( B12) & tests for folate level
10.75Se HCAT ( Selenium Homo Taurocholate ) for bile acid & bile salts malabsorption
11.Calcium , Phosphate , Alkaline Phosphatase , Magnesium.
12 . Histopathology ( Duodenal biopsy )