Gastroenterology Flashcards
Abdominal pain DDx
Pancreatitis - gall stones, alcohol, choolesterol
peptic ulcer - worse after food, lying down
cholangitis - Charcot triad (fever, jaundice, pain)
cholecystitis - murphy Pos, fever
biliary cholic - comes and goes, afebrile
mesenteric ischaemia/ adenititis - vascular hx, sudden onset
appendicitis - central to RIF
bowel obstruction - vomit, constipation, distended
renal colic - loin to groin, severe
pyelonephritis - fever, loin, urinary sx
ectopic - shoulder tip pain, HCG pos, missed period
ovarian cyst torsion/ rupture - severe, iliac fossa, vomit, unwell
PID - vaginal discharge, cervical excitation
AAA rupture - abdomen to back pain, unwell
Dyspepsia (heartburn) refer
2WW
- >55yo with weight loss AND one of following:
- upper abdo pain
- reflux
- dyspepsia
Routine
- Stable haematemesis
- >55yo with one of following:
- treatment resistent dyspepsia
- upper abdo pain and anaemia
- raised platelets + GI symptoms/ weight loss
Dyspepsia Mx (no red flags)
1st - PPI 4-8 weeks
2nd - Ranitidine
H. pylori testing - stool antigen test
Irritable bowel syndrome Fx
> 2 of the following:
- altered stool passage
- abdominal bloating
- passage of mucus
- worse with eating
- other symptoms that make IBS more likely: lethargy, naussea, backache, bladder dysfunction
IBS Ix
RULE OUT OFTHER CAUSES
Bloods - fbc, esr, crp, coeliac screen (TTA)
Faecal calprotectin - POS in IBD
Colorectal Ca referral criteria
2WW criteria
>40 + weight loss + abdominal pain
>50 + rectal bleeding
>60 iron def anaemia or change of bowel habit
FIT Criteria
> 50 with abdominal pain or weight loss
<60 change of bowels or iron def anaemia
> 60 anaemia even in absence of iron deficiency
Ulcerative colitis severity
Mild-Mod
Bowel movements - <6
Severe
Bowel movements >6/ day + systemic upset
Blood in stool
pyrexia
tachycardia
anaemia
raised ER
abdominal tenderness
