Gastrointestinal Flashcards
Main Function of GIT
Break down food and convert to suitable energy source
Liver
- Carbohydrate, lipid and protein metabolism
- Processing of many drugs
Gall bladder
Stores and concentrates bile produced by liver
Pancreas
Produces digestive enzymes and hormones such as insulin
Oral Thrush (Candidias) Symptoms
- Creamy, white soft elevated patches that can be wiped off to reveal underlying erythematous mucosa
- Pain
- Altered taste
- Burning tongue
Oral Thrush Cause
- Candida albican fungus
- Overgrowth of fungus similar to a yeast infection
Oral Thrush Tx
- Miconazole Oral Gel 2%
- Nystatin Oral Drops
- But also Refer to GP
Dyspepsia Symptoms
- Recurrent pain in upper abdomen
- Upper abdomina fullness
- Bloating
- Belching
- Nausea and/or vomiting
- Heartburn
Dispepsia Conditions
- Functional dyspesia
- GORD
- Gastritis
- Duodenal ulcer
- Gastric ulcer
GORD Cause
- lower oesophigeal sphincter incompetence from medicines or overeating
Gastritis Cause
Acid production from NSAIDs or alcohol
Gastric Ulcer Symptoms
- Localised mid-epigastric pain
- Constant gnawing pain
- When stomach is empty
- Worsened by caffeine and alcohol
- Weight loss
- GI bleeds
- Regular NSAID use
Duodenal Ulcer Syptoms
- Pain 2-3 hrs after eating
- Pain waking person at night
Dyspepsia Tx
- Antacids
- Alginates
- H2 antagonists
- Proton pump inhibitors
Dyspepsia Counselling
- Low fat diet
- Reduce alcohol intake
- Reduce caffeine intake
- Lose weight
- Smoking cessation
Antacid Counselling points
- Magnesium salts may cause diarrhoea
- Aluminium salts may cause constipation
Constipation Symptoms
- Reduction in normal bowel habit accompanied
- Difficult defaecation
- Hard stools
- Abdominal discomfort and bloating
Constipation Cause
- Increase in intestinal tract transit time of food which allows greater water resorption from the large intestine
- Lack of fibre
- Change in lifestyle, medication or environment
Constipation Hx to Determine
- Change of diet
- Pain on defaecation (refer to GP)
- Blood (refer to GP)
- Duration (>14 days refer to GP)
- Lifestyle Changes
- remember constipation is a symptom not a condition
Constipation Tx
- Increase dietary fibre
- Increase water consumption
- Increase excercise
- Laxatives if required
Laxatives
- Bulk-forming
- Stimulants
- Osmotic
- Stool softeners
Bulk Forming Laxatives
- Ispaghula/Psyllium, Methylcellulose, Sterculia
- Mimick increased fibre consumption to increase faecal mass
- Encourage proliferation of clonic bacteria (bulks and softens stool)
Stimulants
- Bisacodyl, senna, glycerol
- Increase GI motility by stimulating colonic nerves
Osmotic Laxatives
- Lactulose, Macrogols
- Retains fluid in the bowel by osmosis
Stool Softeners
- Liquid Paraffin, Docusate
- Lubricates bowel wall and softens faecal mass
Diarrhoea
NOT a disease, but symptom of underlying problem such as infection or GI disorder
- Frequent passage of watery stools
Diarrhoea Classification
Acute: 14 days
Chronic: > 30 days
Diarrhoea Aetiology
Viral: Rotavirus, Adenovirus
Bacterial: Campylobacter, Eschericia coli, Salmonella, Shigella - refer
Protozoal: Cryptosporidium, Giardia - refer
Diarrhoea Differential Diagnosis
PPT: Gastro II slide 7
Diarrhoea Tx
- Loperamide
- Diphenoxylate
Diarrhoea Counselling
- Eat bland diet
- Keep hydrated
- Encourage regular handwashing
IBS Symptoms
- Abdominal pain
- Aletered defaecation - constipation or diarrhoea
- Bloating
- Mucus in stools
- Diarrhoea on wakening or shortly after meals
- Consider IBS if it has been a problem for atleast 6 months
IBS Tx
- Antispasmodis for pain
- Mebeverine 135mg
- Hyoscine butylbromide
- Fibre products or movicol for constipation
- Loperamide for diarrhoea
IBS Counselling
- Increase fibre
- Try to find trigger
- Keep up fluids
- Reccommend seeing a gastroenterologist and getting regular colonoscopies
Haemorrhoids (Piles) Symptoms
Swollen and inflamed varicose veins found inside rectum and outside anus
- Bleeding
- Itching
- Mucus discharge
- Pain (dull ache, severe when passing stools)
Haemorrhoids Cause
- Repeated straining on toilet
- Causes veins to become stretched and swollen and lose elasticity
- Blood collects in these veins and engorges and balloons
Haemorrhoids Tx
- Increase fibre and water consumption
- Bulk-forming laxatives
- Anaesthetics (Cinchocaine)
- Corticosteroids (Hydrocortisone)
- Zinc oxide
Threadworm (Pinworm) Symptoms
- Itching worse at night
- Worms escaping anus or in stools
Threadworm Transmission
- Retro-infection
- Inhalation
- Autoinfection
Threadworm Tx
- Mebendazole
- Pyrantel
- Hygeine
Threadworm Counselling
- Treat all family members
- Repeat treatment after 14 days
- Clean linen and clothes
