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Minor Ailments > Gastrointestinal system > Flashcards

Gastrointestinal system Flashcards

1
Q

Dyspepsia definition

A

Is a collection of symptoms including upper abdominal discomfort, pain, heartburn, acid reflux, with or without bloating, nausea and vomiting related to eating.
Typically present for 4 or more weeks

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2
Q

Dyspepsia referral symptoms

A
  • GI bleeding
  • Difficulty swallowing
  • Progressive unintentional weight loss
  • Persistent vomiting
    All require an urgent appointment with the GP
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3
Q

Differential diagnosis of dyspepsia

A
  • Cardiac pain is similar to dyspeptic pain (look out for symptoms such as pain travelling down the arm which doesn’t get relief from antacids as well as cold/clammy/breathing difficulties all signify cardiac pain)
  • Irritable bowel syndrome look out for changes in bowel habits
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4
Q

Treatment options

A
  1. Antacids
    Best given before bedtime and after meals.
    Should not be taken the same time as other medications as it may impair the absorption.
    Magnesium and Aluminium combination antacids are the most effective for GI upset - Magnesium alone can cause diarrhoea whereas aluminium can cause constipation
  2. H2 receptor antagonists
  3. Proton pump inhibitors
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5
Q

Treatment options for Dyspepsia

A
  1. Antacids
    Best taken after meals and before bedtime
    Best to not take with other medication as it may impair absorption
    Most effective are magnesium and aluminium combination - magnesium alone causes diarrhoea and aluminium alone causes constipation
  2. H2 Receptor antagonist
  3. Proton pump inhibitor
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6
Q

Practical tips for dyspepsia

A
  • If overweight, weight loss can help
  • Smoking cessation
  • Avoid trigger foods - chocolate, alcohol, caffeine, spicy foods
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7
Q

GORD

A

An unpleasant burning feeling in the chest accompanied with sour or bitter taste in the throat.

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8
Q

Treatment options for GORD

A
  • Proton pump inhibitor
    Omeprazole 10mg tablets can be sold in over 18’s for a maximum of 4 weeks
    Esomeprazole is licensed for over 18’s for a maximum of 14 days
  • Gaviscon liquid
    Ask patients if they have a referral to a endoscopy as they are not allowed PPI’s for two weeks beforehand as they may mask pathology
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9
Q

Practical tips for GORD

A
  • Weight loss
  • Smoking cessation
  • Avoid trigger foods
  • Eating smaller meals
  • Raising the head of the bed
  • Avoid going to bed straight after a meal
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10
Q

Colic

A

Starts when a baby is a few weeks old and ends at around 4 to 5 months of age. No one knows the actual cause - lactose sensitivity, wind, bowel cramps or baby-detecting anxiousness of parents
- Excessive crying for at least 3 hours a day, for three days a week for at least three weeks

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11
Q

Symptoms of colic

A
  • Sudden crying - high pitched and nothing helps
  • Crying same time each day
  • Might draw their legs up and belly looks swollen
  • Baby may clench their hands
  • Baby’s face flushes
  • Crying lasts for minutes or hours
  • Crying often calms down when the baby is exhausted or when they have passed stool/wind
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12
Q

Referral symptoms for colic

A
  • A floppy baby with reduced responsiveness/alertness would need meningeal symptoms ruled out
  • Post natal depression
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13
Q

Practical tips for colic

A
  • Hold baby in upright position to help pass wind
  • If breastfeeding, allow baby to finish one breast before offering the other
  • If breastfeeding, avoid foods in diet that may affect the baby (caffeine, spicy food, alcohol, chocolate or dairy products)
  • If bottle feeding, ensure the hole on the teat is the correct size.
  • Baby massage may help
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14
Q

Treatment options for colic

A
  • Simethicone in infacol
  • Gripe water
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15
Q

Constipation

A
  • Reduced frequency of defecation
  • Requires straining
  • Passage of small, hard stool
  • Abdominal cramps
  • Incomplete bowel emptying
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16
Q

Danger symptoms of constipation

A
  • Rule out colorectal cancer - new or worsening constipation, blood in stools, weight loss, nausea and vomiting
  • Faecal compaction will require manual evacuation
17
Q

Treatment options

A
  • Laxatives are not recommended
  • Lifestyle measures should be taken first and if there is no improvement, then it may be necessary to give drug treatment
18
Q

Constipation in pregnancy

A
  • Stimulant laxative i.e. Senna, bisacodyl can be used for a short time but needs to be stopped in third trimester as it may induce uterine contractions
  • Bulk forming and osmotic laxatives are the safest
19
Q

Practical tips for constipation

A
  • Drink at least 8 glasses of water a day
  • Avoid too much caffeine
  • Eat food rich in fibre - fruit, veg, wholegrain cereals,
  • Take regular exercise
20
Q

Diarrhoea

A

Frequent passing of watery stools
Cramps and abdominal pain
Vomiting and headache

21
Q

Danger symptoms of diarrhoea

A

Drowsiness or confusion
Passing little urine
Dry mouth and tongue
Sunken eyes
Weakness
Cold hands and feet
Diarrhoea for three days in older children and adults requires referral - 48 hours in 1 to 3 years and elderly + 24 hours in babies under 1

22
Q

Treatment for diarrhoea

A
  • Diarolyte OTC - Made up to 200mL with boiled and cooled water. Drink after each loose stool and any unused portion can be stored in the fridge for 24 hours.
  • Drink plenty of fluids
  • Loperamide for over the age of 12
    Two capsules initially and then one capsule after each loose stool. Maximum 16mg per day.
23
Q

Practical tips for diarrhoea

A
  • Drink plenty of fluids to prevent dehydration
  • Eat as normally as possible
  • Always wash your hands after going to the toilet
  • Regular cleaning of the toilet including flush handle and toilet seat
  • Specialist advice for those whose job it is handling food
  • Refer if symptoms do not improve within 3 days
  • Earlier referral if persistent vomiting, blood in diarrhoea or vomit, drowsiness or confusion, concerns about dehydration
24
Q

Irritable bowel syndrome

A

Chronic, non-inflammatory bowel condition
Recurrent abdominal pain
Change in bowel habit
Alternating constipation and diarrhoea
Abdominal discomfort
Passage of mucus
Faecal urgency

25
Q

Danger symptoms of IBS

A

Rectal bleeding associated with a change in bowel habit
Systemic symptoms requires urgent referral
If bleeding from hemorrhoids, referral not necessary

26
Q

Treatment options for IBS

A

Bulk forming laxatives for constipation OTC
Loperamide for diarrhoea for over 12 years OTC
Anti-spasmodics i.e Mebeverine/Alverine citrate for over 12 years POM only

27
Q

Practical tips for IBS

A

Exercise should help improve the condition
Increase dietary fibre if constipation is a problem
Increase fluid intake
Avoid trigger foods
Reduction in alcohol, smoking and caffeine

28
Q

Hemorrhoids

A

They arise in the upper anal canal and lower rectum
Becoming a problem when they enlarge
Bleeding is common - appears as bright red blood on the stool not mixed with it

29
Q

Danger symptoms of hemorrhoids

A

Excessive bleeding accompanied with change in bowel habit and weight loss. Refer to a routine appointment
Refer patients over 40 with rectal bleeding that lasts longer than 3 weeks accompanied with change in bowel habit
Refer patients over 60 with symptoms alone or together and have lasted longer than 3 weeks

Blood mixed in with the stool and rather than on the surface could indicate colorectal cancer and requires referral

30
Q

Practical tips for hemorrhoids

A
  • Avoid straining
  • Keep the anal area clean and free of irritant faecal matter
  • Warm baths are soothing
  • Cold compresses may help to shrink the hemorrhoids
31
Q

Treatment options for hemorrhoids

A
  • Bland soothing agents - allantoin, zinc oxide (protective properties to prevent local irritation)
  • Local anaesthetics - Lidocaine, benzocaine (Alleviates pain, burning and itching - limit use to three-four days)
  • Topical corticosteroids - Hydrocortisone (Reduces inflammation and pain) - max use 7 days
  • Bulk forming laxatives for constipation

Minor Ailments (7 decks)

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