GI Flashcards
SCORES FOR GI BLEEDS
GLASCOW BLACHFORD - upper GI BLEED
OAKLAND SCORE - LOWER GI BLEED
signs of bowel obstruction
- Abdo pain
- vomiting
- obstipation
4.constipation - abdominal distention
6.fecal vomitting
large vs small obstruction
larger: N+v is more of a late sign
constipation happens earlier
small:more n+v
valvulae coniventes seen
constipation occurs later (as poo is already in the distal colon can still be pooed out)
if you suspect bowel obstruction what investigations
what supportive care can be done?
abdominal x ray
ct abdo
analesia
NG tube -decompress
third spacing
fluid moves from intravascular space to interstial space(waste) so now you have less flid in the blood
most common cause of large bowel obstruction
malignacy
difference in vomitting patterns in bowl obstrcution
early - smalll bowel
late- larger
what are we worried about in bowel obstruction
- perforatin
- toxic megacolon
- third spacing !!- these pateints may need LOADS OF FLUIDS
all patients with suspected bowel onstruction should have a
NG TUBE INSERTED
hartmans
is a procedure that usually done on the sigmoid colon, usually and emergency when you have diverticulitis and there has been a perforation so you resect the dodgy bowel and make it a colostomy and the rectum stump you tie off!
how can diverticuliar disease lead to bowel obstruction and which part is most affected
- because repeated bouts of inflammation can cause strictures!
- sigmoid colon
divericultis symptoms
- left iliac fossa pain
- blood diarhea
3.vomitting - fever
- history of diverticular diseas
CEA IS for
bets investigation for bowel obstruction
colon cancer marker
CT with contrast to see
tinkling bowel sounds
found in bowel obsrcution, high pitched
vomitting vs regurgitition
vomitting - active
regurgitation- passive
fecal matter vomitting
bowel obstruction- and due to very strong peristaltic waves retrograde
Ibs symtltoms
Bloating
Cramps (usually after eating or relieved after poo)
Altered bowels (diarrhoea and constipation
Other symptoms
Gas
Mucous in poo
Back ache
how does constipation lead to incontenicnce
because of the obstruction the part before the obstruction the normal pp gets pass the obstruction
what is indigestion
Pain/discomfort in upper abdomen or chest pain fi
-bloating /feeling full
- gas
- belching, burping
-can sometimes imvolves heart burn
is indigetsion and heart burn the same
NO
heart burn more burning chest pain vs indigestion (stomach)
heart burn speicfically reflux whereas indigestion can be a range (spciey food, fatty food, ulcer, nsaids etc)
both conditions can overlap as people with indigetsion can have heartburn sometimes
symptoms of heart burn
chest pain - esp when lying down or after eating
- regurgitation of food into the mouth sour taste
-
lifestyle advice for indigestion
cut down on cofee
cut down on tea
loose weight
stop smoking
sleep in a rasied postion to prevent reflux
dont eat so close to bed time, leave it like 3/4 h
avoid spicy
avoid fatty
signs of constipation
bad breath
bad taste in mouth
pain
abdo distention
fecal impaction
s a more severe, than constipation and often as a result fo chronic constipation involving a large, hard mass of stool that is difficult or impossible to pass, often requiring more aggressive treatment like manual disimpaction or enemas.
phosphate enema
used to help a person empty bowels but you do a DRE before hand to check for impacted stool
someone comes in with constipation you always want to clarify
cancer symomsm
ALARMS
Anemia
loss of weight
anorexia
melena/hematocheiza
swallowing difficulties
common drugs that cause diarrhea
