Gastro Flashcards
Severe epigastric pain radiates to back?
Pancreatitis
What drug used in treatment of IBD can can cause acute pancreatitis?
Aminosalicyclic drugs 5-ASA
Significantly more common with mesalazine compared to sulfasalazine
Mild to moderate flare of UC not responding to oral or topical aminosalicylates?
Add oral corticosteroids such as prednisone
What drug can increase risk of toxic meghacolon?
Anti-motility such as loperamine
What is classed as a severe exacerabtion of UC?
More than 6-8 episodes of bloody stools per day
What is first line analgesia for colitis?
Paracetamol
NOTE: avoid NSAIDS as they can worsen symptoms of colitis
What is transjugular intrahepatic portosystemic shunt? (TIPS)
A procedure that involves inserting a stent to connect portal veins to blood vessels that have lower pressure
What are the indication for TIPS?
-Variceal haemorrhage - when bleeding can’t be controlled
-Used when ascites cannot be controlled
-Second line treatment for gastric varices
-Secondary prevention of variceal haemorrhage
Variceal hemorrhage and liver cirrhosis ?
Patients with liver cirrhosis are at risk of developing portal hypertension, a significant complication of this is oesophageal varices
NOTE: if these rupture can cause upper GI bleed
Prophylaxis management of variceal haemorrhage?
-Propranolol
-Endoscopic variceal band ligation (NICE medium to large varcies)
-TIPS if above measures are n ot successful
How is EVL performed?
-Two-week intervals until all varices have been eradicated
-Proton pump inhibitor is given to prevent EVL ulceration
Typical features of gastric ulcer?
Pain when or shortly after eating
When does pain come on with duodenal ulcer?
An hour or two after meals - worse when hungry relieved by eating
What bacteria is associated with the majority of peptic ulcers?
Helicobacter pylori
What percent of duodenal and gastric ulcers are associated with helicobacter pylori?
95% duodenal ulcers
75% gastric ulcers
