Gastrointestinal Disease

Question 1

Dyspepsia

(Pain / discomfort in upper abdomen after eating or drinking)

Answer 1

Treatment:
- Antacids - reduce acid production (2-3 days)
- Alginates - neutralise excess acid in stomach (immediate but short lived)
- PPIs (proton pump inhibitors) - protect oesophagus from reflux (immediate but short lived)

Red flags:
- Difficulty swallowing
- Unintentional weight loss
- Blood in stool / vomit
- Persistent vomiting
- Over 40 (1st presentation)
- Radiating pain (down arm)

General Advice:
- lose weight if overweight
- smoking cessation
- avoid trigger foods / reduce intake

Question 2

GORD

Answer 2

Treatment:
- Antacids
- Alginates
- PPIs

Red flags:
- Unexplained weight loss
- Difficulty breathing
- Blood in stools / vomit
- Over 40 (1st presentation)

General Advice:
- Avoid trigger i.e. food, smoking, alcohol
- Lose weight if obese

Question 3

Constipation

Answer 3

Treatment:
- Laxatives
osmotic = 2-3 days
stimulant = 8-12 hours (e.g. Senna, Bisacodyl)
- Stool softeners
- Glycerol suppositories

Red flags:
- Blood in stools
- Bleeding from rectum
- Nausea / vomiting
- Abdominal pain
- Changes in bowel habits

General Advice:
- Drink plenty fluids
- Change diet

Question 4

Diarrhoea

Answer 4

Treatment:
- Dioraylyte sachets
- Immodium capsules (2-4 hours) e.g. loperamide

Red flags:
- Blood in stool
- Mucus in stool
- White fat like liquid in stool
- Abdominal pain
- Changes in bowel habits
- Lasts >1 day child <1, >2 days child <3 + elderly, >3 days adults

General Advice:
- Drink plenty fluid (avoid dehydration)
- Wash hands after using toilet
- Clean toilet regularly

Question 5

Irritable Bowel Syndrome (IBS)

Answer 5

Treatment:
- Laxatives
- Loperamide capsules
- Mebeverine tablets (ease cramping pain + spasms)

Red flags:
- Blood in stools
- White fat like liquid in stool
- Abdominal pain
- Unexplained weight loss
- Changes in bowel habits
- Rectal bleeding

General Advice:
- Increase physical activity
- Increase fibre intake
- Identify + avoid trigger foods / drinks
- Reduce smoking, alcohol, caffeine intake

Question 6

Haemorrhoids (piles)

Answer 6

Treatment:
-

Red flags:
- Blood in stools
- Unexplained weight loss
- Severe abdominal pain
- Changes in bowel habits
- Symptoms lasting >3 weeks

General Advice:
- Don’t strain when using toilet
- Avoid sitting for long periods of time

Question 7

Threadworm

Answer 7

Treatment:
- Mebendazole (1-2 days, 2nd dose in 2 weeks)

Red flags:
- Insomnia
- Unexplained weight loss
- Repeated occurrence
- If travelled abroad

General Advice:
- Ensure good hygiene practices (wash hands after toiler, before eating / preparing find)
- Cut nails short
- Wash bedding + towels daily