GI Management Flashcards
Acute Pancreatitis
Fluids, analgesia and nutrition
Chronic Pancreatitis
CREON
Alpha 1 antitrypsin deficiency
inhalers/IV AAT replacement therapy
Wilsons
Penicillamine and Trientine
Haemachromtosis
Venesection (if this not available then = deferasirox or desferrioxamine)
PBC
Ursodeoxycholic acid
PSC
stent/ balloon/ transplant
Acute appendicitis
surgery
Bleeding peptic ulcer
IV omeprazole
Adrenaline Injection, Heater probe, clips, haemospray
perforated peptic ulcer
surgery
Gastroparesis
Domperidone
pro-motility agents = metoclopramide
gastric pacemaker
eat little and often
Autoimmune gastritis
B12 replacement
Gallstones
No symptoms - nothing
Symptoms - cholestectomy
Cholangiocarcinoma
Surgery - bile duct and liver resection
Palliative - stent
Gallstone Ileus
Urgent Laparotomy, interval cholecystectomy
Cholestasis
ERCP, treat underlying pathology
Biliary Colic
Painkillers
cholestectomy
low fat diet
Ursodeoxycholic acid
acute cholecystitis
IV antibiotics, fluid and analgesia
Acute Mesenteric Ischemia
resection if bowel non viable
smaembolectomy if bowel viable
chroonic mesenteric ischemia
antiplatelet therapy if asymptomatic
symptomatic - open or endovascular revascularization
hepatic encephalopathy
lactulose
abx - rifaximin
treat underlying cause
autoimmune hepatitis
prednisolone and when symptoms improve move onto azathioprine
ALD
abstain form alcohol
nutritional support
steroids
liver transplant
MASLD
weightloss and exercise, stop smoking
eosinophilic Oesophagitis
avoid allergen
Omeprazole
dilate stritures
Achalasia
stretching or slicing of LOS
oesophageal varices
Terlipressin if acute
with TIPSS, EVL, SBT
cancers of the oral cavity
review in 2 weeks -
oral - maxillofacial
oropharangeal - ENT
follow up for 5 years
resection+/-adjuvant therapy
Globulus
reassurance
Peptic ulcer disease
if caused by H Pylori = triple therapy
amoxicillin, clarithromycin, omeprazole
if not caused by H Pylori = PPI
GORD
antacids - gaviscon, peptac
PPIs - omeprazole
H2 antagonist - ranitidine
Barrett’s oesophagus
ablation/resection PPIs?
Cirrhosis
Vitamin B diet, no alcohol, treat underlying cause, transplant, nutrition ect
Malignant oesophageal tumours
surgery - resection
Mallory weiss tear
nothing
MASH
weightloss and exercise - prevent progression to cirrhosis
Resmetirom
Crohns
smoking cessation
prednisolone(mild) or Hydrocortisone (severe) - steroids
azathioprine - immunosuppressant
Ulcerative Colitis
Mesalazine (enema or oral)
prednisolone
azathioprine
IBS
Dietary advice
if constipated - reduce fibre and lactuose (laxative)
if diarrhea - increase fibre (antidiarrheaol - loperamide)
Diverticular disease
asymptomatic - high fibre diet and fluid intake
symptomatic - analgesics, laxatives if necessary
if severe surgical resection
colorectal cancer
resection
Mechanical bowel obstruction
nil by mouth
IV fluid
nasogastric tube to decompress stomach
and further management based on causena
anal fissure
fibre, STITZ baths
stool softeners
Diltiazem or GTN
Botox
Surgery
anal fistula
setons
fistulomotomy
LIFT proceedure
permacol plug and paste
glue/permacol
Solitary rectal ulcer
increase fibre and fluid
haemorrhoids
stool softeners, topical creams
HALO/ THD surgery
Milligan morgan and ferguson
rubber band ligation
acute - analgesia, iced glove, NSAID
Rectal prolapse
bulking agent and education on manual reduction
resection
manual reduction
stop straining
dietary advice
Anal cancer
chemo/radiotherapy
Surgical excision for T1NO tumours
abdominal hernia
do nothing,
straining belt
avoid straining
open or laparoscopic repair (esp if high risk of strangulation)
