Gastro 1A Flashcards
(28 cards)
Define constipation
bowel movements that occur less than three times a week
what medications can cause constipation ?
opiates, antiepileptics and antidepressants
management of constipations?
Bulk forming laxative: Isphagula husk
Osmotic laxative e.g. lactulose and macrogols
Treating faecal impaction: high dose osmotic laxative, suppository (bisacodyl) or an enema (docusate sodium)
'’head to toe’’ screening Qs for overdose?
Neurological symptoms: confusion, drowsiness, visual changes
Respiratory symptoms: Shortness of breath, wheeze
Cardiac symptoms: Chest pain, Palpitations
Gastrointestinal symptoms: diarrhoea, constipation, vomiting
what is dyspepsia?
Heartburn and bloating that can happen after eating
upper abdo pain/discomfort, acid reflux, nausea and vomiting
common causes of dyspepsia?
peptic ulcer disease
GORD
what are the key symptoms YOU NEED TO ASK about in features of dyspepsia?
ALARMS:
ANAEMIA
LOSS OF WEIGHT
ANREXIA
RECENT ONSET PROGRESSIVE SYMPTOMS
MASSESS/MAELENA/ HAEMATEMESIS
SWOLLOWING DIFFICULTIES
(alarms or over 55= upper GI endoscopy)
differential diagnosis for dyspepsia?
gastroenteritis
IBS
upper GI malignancy
what is gastritis and its most common cause?
inflammation of the inner lining of the stomach
infection with helicobacter pylori is the most common cause
pathophysiology of gastritis?
bacteria stimulates toxins which activate inflammatory cells this in turn leads to gastritis and destroys acid producing glands
what test for H.pylori?
faecal antigen test and urea breath test (PPIs should be stopped 1-2 weeks beforehand to not interfere with test
eradication therapy for H.pylori?
omeprazole and two antibiotics, classically amoxicillin and clarithromycin
In patients who are penicillin-allergic, the regime would consist of a PPI, clarithromycin and metronidazole.
what medications can cause GORD?
NSAIDs, bisphosphonates and steroids
what can cause gastroenteritis?
viruses: Norovirus and Rotavirus
Bacteria: E.coli, salmonella, shigella and campylobacter
norovirus affects on body (gastroenteritis)
mild fever
lethargy
headache
vomiting
stomach pain
symptoms appear after 12-48hrs after initial infection
symptoms last 1-3 days and virus contagious for up to 2 weeks
symptoms of gastroenteritis?
abdo pain/cramping
watery diarrhoea
low grade fever
dehydration
inability to keep fluids down
vomiting
frequency to open bowels
define haemorrhoids?
enlarged blood vessels (veins) in the anal canal
haemorrhoids red flag symptom?
A change in bowel habit with painless rectal bleed or tenesmus is a red flag!
what is the special test used for haemorrhoids?
proctoscopy
colonoscopy
flexible sigmoidoscopy
what is infectious diarrhea defined as?
acute onset of 3 or more episodes of over 200g of loose/liquid stools within 24 hours,
symptoms of infectious diarrhoea?
food and water intake
recent travel history
medication history- antibiotics
management of infectious diarrhoea?
oral rehydration therapy
Medical: loperamide (if no fever or blood in stool)
antibiotics only if diarrhoea over 7 days and high grade fever
Irritable bowel syndrome symptoms?
abdo pain
constipation/diarrhoea
bloating
fatigue
nausea
incontinence
ask about diet/triggers
RED FLAGS: PR BLEEDING, UNINTENDED WEIGHT LOSS, >50 YEARS, MALAENA
what test differentiates between IBS and IBD
faecal calprotectin
