GI Flashcards
(34 cards)
What are the red flags for bowel cancer?
Blood in stools
Abdominal mass
What are the referral symptoms for vomiting? [6]
Severe abdominal pain
Weight loss
Blood in vomit
Vomiting in
What is the first line treatment for vomiting?
ORT. Antiemetics - Prochloperazine (migraines) - anti-histamines - anticholinergics Acupressure.
What antiemetic is no longer OTC?
Domperidone.
What are the referral symptoms for diarrhoea? [9]
Change in bowel habit in over 50s. Recent foreign travel. Failed treatment. Unable to drink fluids. Blood/mucus in stools. Bouts of constipation Severe abdominal pain. Weight loss. Symptoms lasting >2-3 days in children and elderly. 24 hours diabetics.
How is diarrhoea treated?
ORT.
Anti-motility drugs.
Loperamide is what type of drug?
Anti-motility
What would bismuth be used to treat?
diarrhoea.
What advice should be given to those suffering from diarrhoea? [6]
Drink plenty of clear fluids. Avoid very sugary drinks. Avoid milk and milky drinks. Eat if it does not exacerbate symptoms. Avoid contact with food until better/stay home from work. Maintain good hygiene.
Diabetics with diarrhoea lasting longer than how long should be referred?
24 hours.
Children/Elderly patients with diarrhoea lasting longer than how long should be referred?
2-3 days.
What are the alarm signs indicating a need for referral in those suffering from dyspepsia? [5]
GI bleeding. Difficulty swallowing Unintentional weight loss Abdominal swelling Persistent vomiting
In what circumstances would you refer a patient with dyspepsia to the GP (other than the normal ones)?
Long standing change in bowel habit. Pain which is debilitating or that wakes the patient in the night Referred pain Treatment failure Indigestion with medicines.
What are some examples of antacids that could be recommended for the treatment of dyspepsia?
Rennies
Remegel
What are some examples of some alginates that could be recommended for the treatment of dyspepsia?
Gaviscon
Peptac
What OTC options are there in regards to PPI for heartburn?
Available OTC – omeprazole, pantoprazole and esomeprazole.
The treatment should not exceed 4 weeks without consulting a doctor.
If no symptom relief is obtained within 2 weeks of continuous treatment, the patient should be instructed to consult a doctor.
What are the referral symptoms for constipation?
Blood in stool/tarry stools
Greater than 14 days duration with no identifiable cause.
Middle aged with sudden change in bowel habit with no identifiable cause.
Suspected depression
Weight loss.
How is constipation managed?
First line is lifestyle advice.
Laxatives are used if needed.
What can cause haemorrhoids?
Constipation and straining.
Chronic diarrhoea
Family history
Pregnancy, bowel tumours
What are the referral symptoms for those with haemorrhoids? [6]
Abdominal pain
Blood in stools, unless sinister pathology has previously been ruled out.
fever
PAtients who have to reduce haemorrhoids manually.
Persistent change in bowel habit in middle aged patients.
Severe pain associated with defecation.
How are haemorrhoids treated?
Lidocaine
Astringents: bismuth, zinc.
Anti-inflammatories such as hydrocortisone.
Protecterorants such as shark liver oil.
When would an IBS patient be referred? [8]
Blood in poo. Children under 16. Patients over 45 with recent change in bowel habit. Patients with no history of IBS of no precipitating factors. Fever. Nausea and/or vomiting. Severe abdominal pain. Steatorrhoea.
How is IBS treated?
Antiplasmodics:
Hyoscine - Buscopan
Mebeverine - colofac IBS
Peppermint oil - Colpermin IBS
Laxatives can be recommended, Ispaghula, but lactulose should be discouraged.
Anti-diarrhoeals - loperamide is first line.
Probiotics.
What laxatives can be recommended for IBS?
Ispaghula NOT lactulose.
