Gastro

Question 1

Constipation
- Ddx
- Investigations
- Risks
- Management

Answer 1

Ddx
UTI, appendicitis, PTB

Mg
- Hydration, stop iron tabs, bulk or fibre and basically most laxatives are safe

Question 2

GORD
- Ddx
- Investigations
- Risks
- Management

Answer 2

Ddx
-PET, HELLP, peptic ulcer

Mg
- Avoid foods, sleep on more pillows, metoclopramide, antacids, omeprazole and ranitidine

Question 3

Peptic ulcer disease
- Ddx
- Investigations
- Risks
- Management

Answer 3

Pregnancy is protective

Mg:
Investigation with gastroscopy
Stop smoking
Treat H Pylori
Antacids and PPIs
Don’t use misoprostol

Question 4

IBD
- Ddx
- Investigations
- Risks
- Management

Answer 4

Ddx: anything abdominal painy

Investigations
- Bloods, stool culture
- Sigmoidoscopy/colonoscopy

Risks:
- UC risk is doubled and more PP, CD not
- No change in miscarriage, SB, fetal abnormality, live birth if quiescent disease
-
Mg
- MDT
- Continue most meds (sulfazalazine should have 5mg folic acid whole pregnancy)
- Contraception
- Review delivery plans
- Growth scans
- If biologics given then stop in third trimester and dont give infants live vaccines

Question 5

Coeliac disease
- Ddx
- Investigations
- Risks
- Management

Answer 5

Risks
- Misc, PTB, IGR 1.5 x risk

Management
- Monitor for deficiencies (Ca, Vit D, iron, B12, folate)
- Gluten free diet

Question 6

IBS
Abdominal pain
Appendicitis
Acute pancreatitis

Answer 6

IBS
- USe buscopan, no mebeverine in pregnancy
- Do all the normal avoid constipation stuff

Pancreatitis
- Likely from gall stone, alcohol, consider hypertriglyceridaemia and hyperparathyroidism
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