Gastrointestinal

Question 1

Overall Red Flags

Answer 1

• Difficulty swallowing
• blood in vomit
• bloody diarrhoea
• vomiting with constipation
  -sustained alteration of bowel habit
• Weight loss

Question 2

Red flags for diarrhoea

Answer 2

• blood
• 24hrs in babies under 6 months
• more than 48hrs in elderly and babies over >6months
• weight loss
• alternating with constipation
• no improvement after OTC Tx
• chronic or recurrent diarrhoea

Question 3

Tx / advice for diarrhoea

Answer 3

-oral rehydration (Dioralyte) 1-2 sachets dissolved in 200-400ml of water
- keeping hydrated, eating bland foods.

Can offer loperamide 2mg (2 caps initially then one cap after every loose stool (no more than 6 caps daily)

Question 4

constipation RED flags

Answer 4

• Children/ babies with ill symptoms
  -continuous severe pain for 2 days
• unable to do work / illness
• weight loss
• self medication not effective after 4-5 days
• fever /night sweats
  -nausea / vomiting

Question 5

Laxatives - faecal softener

Question 6

Laxatives - bulk forming

Answer 6

• 1st line treatment
• best for small hard to pass stools
• onset of action is 72 hours
  Must advise patient to maintain adequate fluid intake