Gastro-Intestinal System Part 2 Flashcards
Food Allergy Symptoms
Cutaneous
- rashes, urticaria (hives)
GI
- colic (pain in abdomen), vomiting, diarrhoea
Respiratory
- breathing problems
Anaphylactic Shock
Food Allergy Treatment
- avoid food item
Sodium Cromoglicate
Chlorphenamine
Anaphylaxis treatment = adrenaline (epipen)
Gastro-Intestinal Smooth Muscle Spasm Causes
- Irritable Bowel syndrome
- inflammatory bowel disease
- bowel colic in palliative care
Gastro-Intestinal Smooth Muscle Spasm Treatment
Antispasmodics
- Hyoscine Butylbromide (buscopan)
- Mebeverine
Antimuscarinics
- Solifenacin
- Oxybutynin
Antimuscarinics Mode of Action
Reduces intestinal motility
- antagonises the muscarinic receptor, stopping digestion.
Antimuscarinic Side effects
- blurred vision
- urinary retention
- constipation
- dry mouth
- Tachycardia
- pupil dilation
- drowsiness
- angle-closure glaucoma (eye darinage gets blocked)
Antimuscarinic cautions
Diabetes
- as it an cause glaucoma as well
Hyperthyroidism
- as it can also cause tachycardia
Cardiovascular Diseases
Antispasmodics Mode of Action
Direct relaxants of intestinal smooth muscle
Antispasmodics and Antimuscarinics contra-indication
Paralytic Ileus
Bowel motor activity impaired non-mechanically
What are Anal Fissures?
A tear or ulcer in the lining of the anal canal
Symptoms of anal fissures
bleeding and or sharp pain or defecation
Acute Anal fissure (<6 weeks) treatment
Ensure soft stools or easy pass:
- Bulk forming/osmotic laxatives
Burning pain following defecation
- topical local anaesthetic
Chronic Anal fissure (>6 weeks) treatment
Glyceryl Trinitrate rectal ointment
or
Oral/topical
- Diltiazem / nifedipine
What are haemorrhoids?
Swelling of the anal mucosal cushion containing enlarged blood vessels (in or out of anus)
Symptoms of Haemorrhoids
- Pain after defecation
- Bleeding after defecation
- Swellings
- itchy sore skin around anus
Risk factors of haemorrhoids
Pregnancy
Constipation
Lifestyle advice for Haemorrhoids
- Increase fluid intake
- perianal hygiene
Treatment for Haemorrhoids
Constipation
- laxatives (bulk forming)
Pain relief
- Paracetamol or NSAID (no NSAID in rectal bleeding)
- Topical anaesthetics (max few days) Lidocaine
Inflammation
- Corticosteroid preparations (max 7 days)
Hydrocortisone, Prednisolone
What is Reduced Exocrine Secretions (Pancreatin Insufficiency)
Reduced secretion of pancreatic enzymes
Symptoms of Reduced Exocrine Secretions (Pancreatin Insufficiency)
Maldigestion, malnutrition, GI symptoms
Causes of Pancreatin Insufficiency
Cystic fibrosis, chronic pancreatitis, Coeliac Disease (when consuming gluten, immune system attacks body), Zollinger-Ellison Syndrome
What is Zollinger-Ellison Syndrome
A rare digestive disorder that results in too much gastric acid. This excess gastric acid can cause peptic ulcers in your stomach and intestine.
Dietary advice for Reduced Exocrine Secretions
- distribute food between 3 meals and 3 snacks
- avoid difficult digesting foods (peas, beans, lentils, high fibre foods)
- no alcohol
- avoid reduced fat diets
Pancreatin Supplement
it is used to compensate for reduced or absent pancreatic enzymes secretion. Assist with digestion
How to take Pancreatin
- Take with food
If high dose doesn’t work, (stomach acid deactivates pancreatin) so use PPI
- Use enteric coated preparations
- don’t mix with excessively hot food/drink (deactivated by heat)
Side effects of Pancreatin
- Diarrhoea
- Abdominal pain/cramps
- Nausea
- Skin irritation
Cautions with pancreatin
Can irritate the perioral skin and buccal mucosa if retained in the mouth
excessive doses can cause perianal irritation
Contra-indications and patient counselling for pancreatin
Contra-indications
- Nutrizym 22
- Pancrease HL
in children aged or under with cystic fibrosis
Patient Counselling
- good hydration with high dose
