Screening for GI Disease

Question 1

what organs are included in the GI system (7)

Answer 1

esophagus
stomach
pancreas
gallbladder
small intestine
large intestine (appendix)
rectum

Question 2

what are general common GI sx reported (5)

Answer 2

swallowing difficulties
bowel dysfunction
sx change w food ingestion
appendicitis
arthralgia/neuropathy

Question 3

what are 2 swallowing difficulties

Answer 3

dysphagia
odynophagia

Question 4

what are 5 bowel dysfunction sx

Answer 4

color of stool, GI bleeidng
emesis, melena, red blood
constipation
diarrhea
fecal incontinence

Question 5

what are some sx that can change w food ingestion (3)

Answer 5

abdominal pain
belly pain that radiates to the back
non localized shoulder pain

Question 6

what is a quality of visceral pain sites

Answer 6

generally not well localized
- will be within general area

Question 7

who are 2 pt populations that should be screened

Answer 7

> 45yo
NSAID users (chronic NSAID use >1mo)

Question 8

what pain should be screened (6)

Answer 8

back pain + abdominal pain simultaneously
back pain that changes w bowel movement
shoulder pain w/i 48hrs of laparoscopy
RLQ pain (usually appendicitis)
joint pain w rash (usually w IBS)
shoulder, back, pelvic, sacral pain w:
- hx of cancer
- pain changes w eating/bowel movements
- constitutional sx

Question 9

what are some constitutional sx that indicate a needed screen (9)

Answer 9

n/v
diarrhea
malaise
fatigue
fever
night sweats
pallor
diaphoresis
dizziness

Question 10

what are some screening Qs

Answer 10

GI specific sx:
- n/v
- unexplained wt loss/gain
- difficulty swallowing
- heartburn/indigestion
- changes in bowel/bladder function
- constipation/diarrhea

GI specific dx or fam hx
- ulcer
- crohn’s
- anorexia
- abdominal surgery

Question 11

what are some follow up Qs if there is a sx change w eating (8)

Answer 11

before or after / nausea
swallowing / pain / type of food
diet changes or tolerance changes
worse if change position
food intolerance
unusual color or consistency of stool
abdominal trauma/surgery
meds (NSAIDs)

Question 12

what are you thinking ab when asking ab if sx worsen w a change in position

Answer 12

indigestion - sitting up helps
cardiac - laying down helps

Question 13

what are you thinking ab if someone w sx change w eating has had an abdominal trauma/surgery

Answer 13

internal bleeding
- organ bleeding like spleen

Question 14

dysphagia sx

Answer 14

food catching or sticking when swallowed

Question 15

what is achalasia

Answer 15

tightness of ms fibers of the esophagus
- can cause dysphagia
- can occur w age

Question 16

what are they two types of dysphagia you can see

Answer 16

mechanical obstruction
ms incoordination

Question 17

what are associated possible causes of dysphagia (4)

Answer 17

peptic ulcer dz (PUD)
GERD - significant irritation/inflammation
tumor
unrelated GI dz (impact ms coordination)
- stroke, alzheimers, parkinsons, ALS, MS, myasthenia gravis

Question 18

what types of food is more difficult for someone w dysphagia

Answer 18

bigger boluses of foods
rougher textures

Question 19

flag for dysphagia

Answer 19

yellow
referral (soon) - aspiration, choking risk
- possible nutritional issues

Question 20

what is odynophagia

Answer 20

pain w swallowing

Question 21

what are possible causes of odynophagia

Answer 21

esophagitis
- GERD
- virus/fungus (ie herpex, fungi from antibiotic usage)

Question 22

how can you differential dx odynophagia

Answer 22

coronary ischemia
- supine or nitroglycerine relieves coronary ischemia

esophagitis - being upright relieves

Question 23

flag for odynophagia

Answer 23

yellow
- medical referral (emergent) - cardiac
- medical referral (followup) - GERD