DYS Flashcards
Upper abdominal discomfort
Bloating
Trigger:
Spicy / Acidic food
Large meal
Alcohol
INDIGESTION
What to treat indigestion?
Antacids
E.g. sodium bicarbonate, aluminium hydroxide
Symptomatic relief
Liquid > Solid
Most effective taken 1 hour after meal
High Na+
SE: constipation / diarrhoea
Mg: diarrhoea, Ca/Al: constipation
H2 antagonist
E.g. cimetidine, ranitidine (Zantac)
Block histamine, reduce gastric acid secretion
Slow onset, long duration
No pregant / breastfeeding
PPI
E.g. esoperazole, omeprazole (10mg OD, max 28tab)
Block gastric acid secretion
Stop when complete relief
Up to 2 days to have effect
Refer if no change in 2 weeks
OK in pregant / breastfeeding
What to treat bloating/wind?
Simeticone
Reduce surface tension, eliminate gas
Advice for indigestion?
Avoid spicy & high acid foods aggravate indigestion
Avoid eating 3 hrs before sleep
Avoid smoking and alcohol
Avoid ibuprofen/aspirin (worsen)
Burning discomfort, Pain in stomach upwards (behind sternum)
Worse after eating
Worse on bending / lying down
Regurgitation in back of throat
Trigger:
Alcohol
Smoking
Obesity
Pregnancy
HEARTBURN
When to refer INDIGESTION?
Children
>45yrs first time
Severe pain
Blood (tarry stool)
When to refer HEARTBURN?
Treatment fail
Pain radiating to arms
Difficulty swallow
Children
Treatment for HEARTBURN?
Alginate (Gaviscon)
Form a raft on stomach
Fast-acting
Safe in pregnancy
Advice for HEARTBURN?
Avoid bending
Avoid tight clothes
Avoid smoking
Avoid alcohol
Avoid caffeine + chocolate (makes oesophageal sphincter less competent)
Avoid ibuprofen + aspirin (worsen)
Lose weight if obese
Lumps inside/around bottom
Bright red blood after poo
Itchy anus
Pain around anus
Trigger:
Constipation
Pushing too hard when in toilet
HAEMORRHOIDS
When to refer for HAEMORRHOIDS
Treatment fail
Worse/no better after 7 days
High fever
Treatment for HAEMORRHOIDS
Anusol Cream / Ointment
Wash hands and affected area
Apply to affected area at night and morning and after each evacuation until condition is controlled
Wash hands after application
SE: rash (very rare)
Pregnant - diet first, meds need doctor/midwife
Advice for HAEMORROIDS
Plenty of fluid
Increase fibre intake
Keep bottom clean + dry
Wipe bottom with damp toilet paper / do not wipe too hard
Do not push too hard when pooping
ONLY paracetamol for pain
burning pain in your tummy, few minutes to a few hours, and often starts within a few hours of eating. You may also wake up in pain during the night
Stomach ulcer - REFER
SUPPOSITORY Counselling (Glycerol)
Wash hands
Tear one from the strip and peel it from the plastic wrapping
The tip should be moistened with cold water to aid insertion
Lie on your non-dominant side, draw your knees up towards chest
Using your index finger, gently push the suppository into rectum, tip first
Insert as far as possible
Lower legs to a comfortable position to help you hold the suppository in place
Retain the suppository in place for 15-20 mins.
Wash hands
You may feel the urge to go to toilet. Go after 15 mins
