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GI 09 Flashcards

1
Q

Constipation ki ?

A

Hard to empty their bowels, or have infrequent bowel movements.

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2
Q

Goal of Treatment of Constipation ?

A

3 goals

  1. Identify and treat secondary causes.
  2. Relieve symptoms
  3. Restore normal bowel function.
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3
Q

Non pharmacological Treatment of constipation

A
  • Increase dietary fiber
  • Drink at least 2 L of fluid.
  • Exercise 10-15 minuates each day.
  • Respond to urge of bowel movement.
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4
Q

Pharmacological treatment for constipation?

A

Laxatives

  1. Bulk-forming laxatives
  2. Stool softeners
  3. Stimulant laxatives
  4. Osmotic laxatives.
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5
Q

Constipation 1.Bulk forming laxatives

A

Ex: Metamucil

  • Create mass and then promotes stool by peristalsis/wave of the intestinal wall.
  • The effect can see 12-24 hours or 72 hours
  • Side effect: Flatulence, abdominal distension
  • Safe in pregnancy and good for them.
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6
Q

Poloxamer ki ?

A

Non-ionic surfactant with similar properties like docusate.

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7
Q

Pharmacological treatment of Constipation 2. Stool softener ?

A

Ex: Coloxyl oral drops
-Good for Mild constipation (similar like docusate) Specially prevention of haemorrhoids.

-Work as softener and stimulant.

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8
Q

Pharmacological treatment of Constipation 3. Stimulant laxative.

A

Ex:Coloxyl (Bisacodyl)

  • Increase Gut motility and irritate colon lining to create contraction.
  • Quick 6-12hurs
  • Abuse can lead to weight loss
  • So monitoring required
  • Identify and refuse to sell or recommended to go to dr.
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9
Q

Pharmacological treatment of Constipation 4.Osmotic laxative

A

Ex:Laevolac
Retaining fluid in the bowel
Side effects: Flatulence and abdominal pain
Can work quick for some ppl but not for all

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10
Q

Diarrhoea ?

A

Increase frequency of loosen stool with cramp and pain.

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11
Q

Common causes of diarrhoea ?

A
  • Viruses and bacteria (most common cause)
  • Medications
  • Irritable Bowel Syndrome (IBS)
  • Medical conditions (coeliac disease, inflammatory bowel disease)
  • Diet or food intolerances (e.g. lactose intolerance)
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12
Q

Red flags for Diarrhoea

A

Elderly, children and infents. as they can go to dehydration faster.

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13
Q

Treatment GOAL of Diarrhoe

A
  • Relieve symptoms.
  • Hydration and
  • Treat underlying cause. Cause some times it can be sudden (food poisoning) and sometime it can be from long time.
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14
Q

Treatment of Diarrhoea? Non pharamcological

A

Oral rehydration therapy (ORT)
Avoid food which irretate the GUT. i.e spicy
Increase bulk forming food like bran and bananas.

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15
Q

Treatment of Diarrhoea? Non pharamcological

A

Oral rehydration therapy (ORT).
Avoid food which irretate the GUT. i.e spicy
Increase bulk forming food like bran and bananas.

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16
Q

Treatment of Diarrhoea? Pharmacological

A

• Anti-motility agents e.g. Loperamide. ( Increasing
intestinal transit time and absorption of water and
electrolytes. Loperamide also reduces urgency by
increasing anal sphincter tone).
• Adsorbents and bulk-forming agents e.g. psyllium. (Reduce diarrhoea
by reducing the fluid in stool and make
stool more solid).

17
Q

Oral rehydration therapy (ORT) ?

A

-Highly effective NP treatment for diarrhoea.
Ex: Enerlyte, Pedialyte, Hydralyte
-(NB)Sports drinks or other soda water has no sodium but sugar.

18
Q

Hemorrhoids

A

Hemorrhoids are swollen veins in the lower rectum.

  • Hemorrhoids/“piles”.
  • 50% of adults suffer at some point.
  • Vascular-rich connective tissue cushions become engorged( swell with blood) and swollen.
  • Two types: Internal or External.
19
Q

Causes and symptoms of of Haemorrhoids?

A

-Degeneration of connective tissue because of aging.
-Anal canal pressure from heavy lifting,
-Obesity, chronic diarrhea, Childbirth, standing for long
time.
-From constipation

Symptoms are: bleeding from rectal area.specially after a bowel motion.
And Pain

20
Q

Red flags for Haemorrhoids

A
  • 3 weeks or longer.
  • Sharp or stabbing pain
  • Going large volume of blood
  • Nausea, vomiting, loss of appetite
  • Over 50 old and complaining of change in bowel habit.
21
Q

Pharmacological and non-pharmacological treatment options for Haemorrhoids

A

Non-Pharmacological

  • Increase fibre in diet
  • Avoid becoming constipated
  • Pharmacological
  • anaesthetics
  • astringents: Zink make a protective code on haemorrhoids.
  • anti-inflammatories
22
Q

IBS Irritable bowel syndrome?

A

Functional disorder. So our Intestine may not contrac on time and relax on time as a result may causing a collection of symptoms
cramping, bloating, diarrhoea and constipation. On the other hand IBD is chronic & lead to more severe complications like weight loss fetigue cancer etc.

23
Q

IBS Non pharmacological treatment

A
  • Diet and lifestyle changes.
  • Smaller and more frequent meal.
  • Avoid alcohol, Caffine & Preserved food.
  • Manage stress
  • Hydration and Excercise.
24
Q

Pharmacological treatment options for IBS

A

Hyoscine Gastrosoothe for bloating and cramping.
Laxatives if constipation
Antidiarrhoeal-Loperamide.for slow down bowel movement.

25
Q

Red flags for IBS

A

Under 16
Over 45
Severity of pain
Blood in stool

26
Q

Threadworms

A
  • Known as pinworm
  • Small, thin, white worms between 2mm and 13mm
  • Children 5 and 14 age.
27
Q

Transmission of Threadworms

A
  • Ingestion of eggs by mouth or nose through inhalation.

- Person to person via contaminated clothes and bed linen.

28
Q

Life Cycle of Threadworms

A

After ingestion larva hatched in the small intestine then adults establish into the colon. After ingestion by 1 month, they become ready to give egg and the lifespan is 2 months. Folds of ANAS female lay eggs nocturnally and migrate back to RECTUM.

29
Q

Symptoms/ Clinical manifestations of Threadworms

A

Itchy anas
Teeth grinding
Loss of apitite
Abdominal pain

30
Q

Red flag for Threadworms

A

Pregnent
Under 1 year
Recent travel

31
Q

Hygiene measures for Threadworms

A

Frequently change bedding
Practice good hygine
Treat the whole family.

32
Q

Pharmacological treatment of Threadworm

A

-Mebendazole (VERMOX) (antihelmintic -distroy worm)
Bind to Beta tubulin of worm result immobilization and death.
Over 2 years 100 mg and repeat after 14 days.
SE: Abdominal pain and diarrhoea.
-Pyrantel (Nuromuscular blocking agent).
Dose determines by body weight 10mg/kg
SE same like mebendazole..

33
Q

Diagnosis of threadworm ?

A

Via symptoms or looking for it.
Look for worms in the anal region when asleep.
Can use transparence tape.

34
Q

Treatment options for Thredworm is and dose ?

A

mebendazole

Over 2 years 100 mg and repeat after 14 to 28 days

35
Q

Mechanism of mebendazole

A

selective binding to beta tubulin of parasitic worm as a result immobilization and death.

36
Q

Side effect of Mebendazole

A

Generally well tolarated

side effect cramp, diarrhoea, abdominal pain etc.

37
Q

Pyrantel also can be an option for treatment for?

A

Thredworm

38
Q

Mechanism of Pyrantel

A

Causing sudden contraction as a result paralysis of the worm and looses grip on the intestinal wall and expelled by peristalsis.

39
Q

Adverse effects of Pyrantel

A

Well tolarated but some times may cause Diarrhoea ,cramp, pain.

GI (16 decks)

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