gastrointestinal Flashcards
(34 cards)
What is an anal fissure?
A tear or ulcer in the anal canal that causes bleeding or pain during defecation.
How are acute anal fissures treated?
Ensure easy stool passage using bulk-forming or osmotic laxatives, and short-term topical lidocaine or analgesics (not in pregnancy).
What is the treatment for chronic anal fissures?
GTN rectal ointment (headache risk), topical/oral diltiazem or nifedipine, or botulinum toxin; surgery if drugs fail.
What is the difference between internal and external haemorrhoids?
Internal haemorrhoids are painless; external are itchy and painful.
Which painkillers are avoided in haemorrhoids and why?
Opioids (cause constipation) and NSAIDs (risk of rectal bleeding).
What is the first-line treatment for coeliac disease?
Strict adherence to a gluten-free diet to prevent symptoms and long-term complications.
What are complications of untreated coeliac disease?
Osteoporosis, malnutrition, and increased cancer risk.
How is Crohn’s disease commonly treated during the first flare-up?
Monotherapy with corticosteroids like prednisolone or IV hydrocortisone; budesonide if distal disease.
Which medicines are used in Crohn’s disease maintenance?
Azathioprine or mercaptopurine; methotrexate if intolerant.
What is fistulating Crohn’s disease and how is it treated?
Fistula formation treated with metronidazole +/- ciprofloxacin; long-term azathioprine or infliximab.
What are symptoms of ulcerative colitis?
Bloody diarrhoea, urgency to defecate, and abdominal pain.
Which medicines should be avoided in ulcerative colitis and why?
Loperamide and codeine, due to risk of toxic megacolon.
What is first-line treatment for proctitis?
Topical aminosalicylates; oral may be added if no improvement in 4 weeks.
What is used to treat severe ulcerative colitis?
IV hydrocortisone or methylprednisolone; ciclosporin or infliximab if steroids fail.
Which side effect is associated with sulfasalazine?
It stains contact lenses orange/yellow and can cause nephrotoxicity and hepatotoxicity.
What are red flag symptoms for constipation?
Blood in stool, anaemia, abdominal pain, weight loss, new onset in patients over 50.
What is the treatment for severe dehydration caused by diarrhoea?
IV fluids are needed.
How is H. pylori diagnosed?
13C breath test or stool antigen test; PPIs stopped 2 weeks before, antibiotics 4 weeks before.
What is the first-line eradication therapy for H. pylori?
Triple therapy: PPI + amoxicillin + clarithromycin/metronidazole for 7 days.
What lifestyle advice is given for GORD?
Weight loss, smaller meals, eating 3-4 hours before bed, raise bed head, reduce alcohol.
How is diarrhoea managed in most cases?
With oral rehydration therapy; IV fluids if severe dehydration.
When is loperamide used?
For rapid control of diarrhoea or for faecal incontinence, but avoid in bloody or inflammatory diarrhoea.
What are the symptoms of dyspepsia?
Upper abdominal pain, heartburn, reflux, bloating, nausea and vomiting.
What are urgent referral signs in dyspepsia?
GI bleeding, age 55+, unexplained weight loss, dysphagia (GAUD).
