GI investigations Flashcards
what are the 4 principles of investigations
- Begin with thorough history and examination
- Differentiate functional disorders from organic pathology
- Start with simple and non-invasive investigation where possible
- Justify all investigations requested
give examples of bedside investigations
BMI Pulse oximetry ECG Capillary glucose Urinalysis
what is looked for in stool analysis
FOB testing
Stool culture
Faecal calprotectin
- Raised level in inflammatory conditions
- Quantitative analysis useful for monitoring disease activity
Faecal elastase
- Investigation of pancreatic insufficiency / malabsorption
what should be looked for in blood analysis
Urea and Electrolytes Calcium / Magnesium Liver Function Tests CRP Thyroid function FBC Coagulation Haematinics (B12, folate, ferritin) Hepatitic screeening Coeliac serology Tumour markers
what other investigations can be done
Urine collections: 5HIAA; catecholamines
Nutrition screen: trace elements, vitamins
Laxative screen
what GI physiology investigations can be carried out
Breath testing
- Urea breath test: H. pylori
- Hydrogen breath test: bacterial overgrowth
- Lactose intolerance
Oesophageal pH and manometry
- Assessment for oesophageal dysmotility
- Assess reflux
what is upper GI endoscopy used for
Under sedation or local anaesthetic
- Examines oesophagus to duodenum
- Allows biopsy and therapeutic intervention
- Oesophageal/pyloric stenting
what are the risks of UGIE
aspiration, perforation, haemorrhage
what is colonoscopy used for
Usually give sedation and
requires bowel preparation e.g. Picolax
- Examine rectum to caecum/terminal ileum
- Allows biopsy / polypectomy / EMR
what are the risks of colonoscopy
perforation; haemorrhage; renal impairment (bowel preparation)
what is endoscopic retrograde cholangio-panceatography (ERCP) used for
Use sedation or GA
- Visualise ampulla, biliary system and pancreatic ducts
- Allows biopsy/cytology; stone removal; stenting; dilatation
what are the risks of ERCP
Pancreatitis; Haemorrahge; Perforation; Infection; Mortality
what is endoscopic ultrasound used for
diagnosis and staging
allows biopsy and cyst drainage
what is enteroscopy used for
Visualise small intestine
Allows biopsy or therapy for small bowel pathology
what are the pros and cons of capsule enteroscopy
+ less invasive
- no biopsy possible
