GI Conditions (FCM) Flashcards
(38 cards)
What is oesophagitis ?
Inflammation of the lining of the oesophagus. which can be caused by infection or irritation of the oesophagus
What is GORD?
Also known as acid reflux.
This occurs when some of the stomach acid comes back up into the oesophagus
How would you treat oesophagitis ?
Treat the acid reflux symptoms with a PPI for 8 weeks.
What risk factors should you ask about if a patient presents with gastritis ?
- Alcohol use
- History of PUD/ H. pylori infection
- Smoker?
- NSAID use
- previous GI surgery
What is the management for GORD
- First line:
Lifestyle
- diet
- exercise
- avoid eating just before bed
- elevate head at night
- eat 5 small meals - PPI (second line)
- omeprazole for 4 weeks
safety net
- if after 4 weeks not made any difference then think about h. pylori testing
What is peptic ulcer disease?
A sore in the lining of the stomach. Most commonly in the duodenum.
What are the acute and chronic causes of a PUD?
Acute:
- stress
- NSAID’s
- Steroids
Chronic:
- Drugs
- H.pylori
What are symptoms of a peptic ulcer? (8 things)
- change in appetite
- weight loss= gastric weight gain = duodenal
- melena
- vomiting
- indigestion
- epigastric pain
- bloating
- burping
What is the treatment for a PUD?
- Conservative:
- offer NHS resources
- lifestyle
(weight loss, avoid trigger foods, smaller meals, eat 3-4 hrs before bed, smoking cessation, reduce drinking) - H.pylori testing if its chronic
- Medication:
- Triple therapy
PPI (omeprazole 20-40mg)
Amoxicillin (1g BD)
Clarythromycin (500mg BD)
TREATMENT FOR 7 DAYS
- can take with or without food
IF ALLERGIES
PPI +
Clarythromycin 500mg BD and metronidazole 400mg BD
What is jaundice ?
A condition where the skin, sclera, and mucus membranes turn yellow due to increased amounts of the waste material bilirubin in the blood
What is achalasia ?
A rare motility disorder that’s characterised by the failure to relax the lower oesophageal sphincter resulting in difficulty swallowing
What is the most common cause of a painless lower GI bleed? and how does this condition present?
Diverticulosis
It presents as:
- LIF pain
- Fresh blood in the toilet bowl (LARGE RECTAL BLEED)
- Intermittent abdo pain
- Bloating
- Diarrhoea or sometimes constipation
- Rectal mucus
How would you manage diverticular disease and then how would you manage diverticulitis?
Diverticular:
1. High fibre diet
Fibre is a carb found in plant based food
e.g beans, whole grains, dried fruits.
(will see benefits in a few weeks)
- Refer to colorectal surgery team
- only if symptoms are persistent
Diverticulitis:
- Hospital referral if unwell, or >65, uncontrolled abdominal pain, can’t have oral abx, co- morbidities or is immunosuppressed
- IF SYSTEMICALLY WELL:
if signs of infection:
- Co- amoxiclav 500/125mg TDS for 5/7
- if allergic to penicillin –> Cefalexin 500mg TDS for 5/7 + Metronidazole 400mg TDS
Otherwise no abx:
- Offer analgesia
- Written info on it
What is pancreatitis and how would this patient present ?
- What RF’s would you look out for?
Pancreatitis is inflammation of the pancreas. mild pancreatitis resolves in a week
Symptoms:
- Acute sudden onset upper or generalised abdominal pain
- Nausea and vomiting
RF’S
- Alcohol misuse **
- History of gallstones
How is Acute pancreatitis managed ?
- ERCP - to relieve the obstruction with possible cholecystectomy
- Surgery - either to drain puss collection or debridement of necrotic tissue
What is the difference between diverticulosis and diverticular disease?
When there are no symptoms, it is called diverticulosis. When diverticula cause symptoms, such as pain in the lower tummy, it’s called diverticular disease.
How do you identify Ulcerative colitis ? (5 things)
- Colicky pain
- Bloody diarrhoea
- Tenesmus
- LLQ abdominal pain
- Weight loss
How do you identify Chrons? (9 things)
- unexplained persistent diarrhoea
- Abdominal pain/discomfort (RLQ)
- Fatigue
- Malaise
- anorexia
- Stool not always bloody
- 5-6 bowel movements per day
- Weight loss
- Granulomas **
What is one of the main differences in Crohn’s and Ulcerative colitis - in terms of symptoms
Crohn’s has extraintestinal symptoms such as nodules on the skin and mouth ulcers - UC doesn’t
Also Crohn’s can occur anywhere from the mouth to the anus and UC only occurs in the colon
How would you expect the bowel to appear in Crohn’s? (6 things)
- cobble stone appearance
- skip lesions
- Transmural changes
- Fat wrapping
- Possible fissure
- Thickened bowel wall
How would you expect the bowel to appear in UC? (5 things)
- psueudopolyps
- ulceration
- loss of haustra
- Mucosal and submucosal inflammation
- continuous inflammation
What is involved in charcot’s triad? and what condition does this link to?
- RUQ pain
2.Fever
3.Jaundice
cholangitis
what is acute cholecystitis &why does it occur?
Inflammation of the gallbladder
it usually occurs when a gallstone blocks the cystic duct
what are the the main symptoms of biliary colic? (4 THINGS)
- Colicky abdominal pain (No more than 6 hrs)
- Pain worse after fatty food
- Sudden dull pain radiating to the right shoulder
- NO FEVER OR ABDO TENDERNESS !
