RTS Gastro-Intestinal System Flashcards
(52 cards)
Define Dyspepsia
A term used to describe a range of symptoms including: - Pain/discomfort in the abdomen - Regurgitation of food or acid re-flux - Nausea and vomiting relating to eating - sour acid taste - fullness, bloating, wind - heartburn
Triggers to dyspepsia
Smoking, Eating late near bed time, Alcohol,
NSAIDS, Being overweight Pregnancy
Key conditions in dyspepsia
Peptic ulcer disease
GORD, duodenitis, gastritis infection by H.Pylori
Danger symptoms in dyspepsia
GI bleeding unintentional weight loss persistent vomiting black ‘tar’ stools cardiac pain (after mistaken for dyspepsia) pain radiating down arm, not relieved by antacids patients above age 45 with first episode ever recurrent
When do you refer for dyspepsia - what drugs??
Dyspepsia caused by POM NSAIDS, Iron, corticosteroid
Dyspepsia first line treatments
combinations of antacids, to be taken after meals and at bedtime e,g Magnesium and Aluminium Alginate rafts to form a barrier and minimise reflux.
Dyspepsia second line treatments
H2 Antagonists e.g ranitidine and famotidine - Inhibit stomach acid production. Short term use. 12 hour relief
Dyspepsia third line treatments
Proton pump inhibitors - Omeprazole/Pantoprazole to suppress acid.
Who shouldnt we give ranitidine or omeprazole to?
under 16’s (ranitidine) and under 18s (omeprazole) and don’t give it to pregnant/breastfeeding women Or liver/renal impairment
Self care for dyspepsia
weight loss, no smoking, avoid trigger foods e.g caffeine/ alcohol/ rich and spicy foods/ take small or regular meals.
What is Nausea?
queasy feeling a person gets before being sick or throwing up
Define vomiting?
body’s way of getting rid of stomach contents it feels may be causing harm
Internal causes of nausea and vomiting
headaches, viral infections, pregnancy, severe pain, heart attacks
External causes of nausea and vomiting
motion sickness, alcohol poisoning, food poisoning, medicines
Other causes of nausea and vomiting not so common?
Allergy, Stress, cancer, overeating
Nauseas and vomiting - when do you refer?
Pregnant women. Dehydrated following ORT. Food poisoning, e.g E.coli. Infant/Child <6 Not urinated in last 6 hours.
what calls for urgent referral where you might want to give Dr an added note
Blood in vomit (bright red or looks like ‘coffee grounds’) Severe headache or stiff neck Lethargy, confusion or decreased alertness Rapid breathing or pulse
Drug treatments for nausea
Prochlorperazine, buclizine ( for migrane and for Prochlorperazine vomiting) Promethazine, Cinnarizine, Hyoscine (travel sickness) Bismuth subsalicylate (nausea due to dyspepsia)
Treatment for pregnant women with travel sickness or morning sickness in pregnancy
Accupressure bands
Nausea and vomiting self care
Small frequent sips of water, small meals if possible, rest and ginger tea/biscuits
what do you want to do at the end of any consultation?
make recommendations on websites such as nhs choices and patient.co.uk. As patient if they understand, and if they have any questions, where they should go
Define GORD
unpleasant burning feeling felt behind breastbone, accompanied by a sour or bitter taste in the throat caused by reflux or GI contents into the oesophagus
what actually causes heart burn?
The gullet does not have a protective lining, and so it becomes sore and inflamed when acid rises up from the stomach
Common symptoms of GORD
Burping, A sour acid taste in back of throat. Discomfort that gets worse after eating, lying down or bending over. Bloating. Burning feeling in chest! and pain behind breastbone.
