GI Investigation Flashcards
How should you start investigations for patients presenting with altered bowel habit, diarrhoea or constipation, and rectal bleeding?
With simple and non-invasive procedures if possible, to avoid unnecessary discomfort for the patient
What bedside investigations should be done for a patient presenting with altered bowel habit, diarrhoea or constipation, and rectal bleeding?
BMI Pulse oximetry ECG Capillary glucose Urinalysis
What other non-invasive investigations should be done for a patient presenting with altered bowel habit, diarrhoea or constipation, and rectal bleeding?
Stool culture Faecal calprotectin Faecal elastase Blood analysis Urin collections Nutrition screen Laxative screen Breath testing
Why is testing for faecal calprotectin useful?
Raised in inflammatory conditions, is useful for monitoring activity of a known disease
Give 6 blood analysis investigations that could be done in a patient presenting with altered bowel habit, diarrhoea or constipation, and rectal bleeding
U&Es Calcium/magnesium LFTs CRP Thyroid function FBC Coagulation Haematinics Hepatic screen Coeliac serology Tumour markers
Why is it important to test for magnesium and calcium?
If magnesium is low then low calcium levels will be difficult to treat
What investigations might be done to assess oesophageal dysmotility and reflux?
Oesophageal pH and manometry
What endoscopic investigations might be done for a patient presenting with altered bowel habit, diarrhoea or constipation, and rectal bleeding?
Upper GI endoscopy Colonoscopy ERCP EUS Enteroscopy Capsule enteroscopy
What regions of the GI tract can be examined through an upper GI endoscopy?
From oesophagus to duodenum
What are the risks associated with an upper GI endoscopy?
Aspiration
Perforation
Haemorrhage
What regions of the GI tract can be examined using a colonoscopy?
From the rectum to the caecum/terminal ileum
What are the risks associated with a colonoscopy?
Perforation
Haemorrhage
Renal impairment due to bowel preparation
What can be visualised using ERCP?
Ampulla, biliary system and pancreatic ducts
What can be carried out during ERCP?
Biopsy/cytology
Stone removal
Stenting and dilation
What are the risks associated with ERCP?
Pancreatitis Haemorrhage Perforation Infection Mortality
