11. Signs and Symptoms of Abdominal Disorders Flashcards
What are the common presentations of abdominal disorder?
Dyspepsia, abdominal pain, constipation/ diarrhoea, dysphagia.
What is dyspepsia?
Upper abdominal pain/ bloating, chronic or recurrent pain or discomfort in the upper abdomen.
What can cause dyspepsia?
Chronic peptic ulcer disease, GORD, malignancy, functional/non ulcer.
How can dyspepsia be managed?
Empirical acid suppression, non invasive H-pylori testing and eradication, early endoscopy.
How common is abdominal pain in hospital admissions?
2% of all admissions.
What are some foregut causes of abdominal pain?
Ulcers-epigastric pain, pancreatitis, gallstones.
Where does pain present with pancreatitis?
Epigastric pain, back pain (as it is retroperitoneal).
Where does pain present with gallstones?
Epigastric apin, right upper quadrant pain - colicky pain.
What are the causes of real colicky pain and how are they distinguishable?
Small bowel and large bowel. Small bowel pain is every 2-3 minutes, large bowel pain is every 10-15 minutes.
What is the presentation of small bowel obstruction?
Vomiting fairly early, abdominal distension and pain.
What is the X ray of small bowel obstruction like?
Central abdominal distended loops, circular folds extending width of bowel lumen.
What is a common cause of hindgut pain?
Sigmoid volvulus.
What is sigmoid volvulus?
The sigmoid twists on itself or its mesentery, there is bowel obstruction so absolute constipation and the blood supply is interrupted so tissue dies.
What is anorexia?
Loss of appetite.
What can cause anorexia?
Cancer, chemotherapy/ certain antibiotics, pregnancy, depression, endocrine disorders, psychological disorder, anger/ fear, anxiety.
What is important to clarify in a history with weight loss?
Whether it was intentional or unintentional.
When does unintentional weight loss need investigation?
When it is more than 5% of total body weight.
What is nausea?
Subjective sensation of the need to vomit.
What are the common causes of nausea?
Food poisoning, gastroenteritis, cholecystitis, appendicitis, viral hepatitis, pancreatitis, intestinal blockage, pain.
What is constipation classified as?
Less than three times a week depending on normal habits.
What are the causes of constipation?
Diet, medication, dehydration, immobility, disease-neurological (stroke), functional.
What is diarrhoea?
It varies from person to person, but is more stools or a change in consistency.
What are the categories of diarrhoea?
Secretory, osmotic, abnormal intestinal motility, exudative, malabsorption.
What causes secretory diarrhoea?
Infection.
What causes osmotic diarrhoea?
Lactose intolerance.
What causes abnormal intestinal motility diarrhoea?
Thyrotoxicosis, IBS.
What causes exudative intestinal diarrhoea?
Colitis, cancer.
What causes malabsorption diarrhoea?
Pancreatic enzyme or bile salt deficiency.
What is dysphagia?
Difficulty swallowing, can be solids or liquids.
What is odynophagia?
Painful swallowing.
What are the broad categories of dysphagia and their causes?
Difficulty initiating swallow from neurological causes, food sticking in oesophagus from anatomical problems.
What can cause bleeding from the top of the GI tract?
Acute/chronic peptic ulcers, Mallory-Weiss teat, oesophageal/gastric varice, erosive oesophagitis, gastric/oesophageal cancer.
What can cause bleeding from the bottom of the GI tract?
Angiodysplasia, diverticular disease, colonic carcinoma, haemorrhoids/ anal fissure, inflammatory bowel disease, massive upper GI bleed.
What does a massive upper GI bleed cause?
Malaena.
What can cause abdominal distension?
The 5 F’s: fat, fluid, faeces, flatus, foetus.
What is fluid-ascites?
Abnormal amounts of fluid in the peritoneal cavity.
What can cause fluid-ascites?
Liver failure, portal hypertension, cancer.
What can cause flatus?
Aerophagia - swallowing air, or gas production in the gut - especially with incomplete digestion.
