GI Symptoms Flashcards
What is anorexia?
Anorexia is loss of appetite and/or lack of interest in food.
What is weightloss?
Weight loss is usually the result of reduced energy intake, not increased energy expenditure.
This can result from:
- Dieting
- Loss of appetite
- Malabsorption or Malnutrition
How can diabetes mellitus contribute to weightloss?
Glycosuria can cause energy loss in uncontrolled diabetes
What can lead to increased energy expenditure?
Hyperthyroidism
Fever
Adoption of more energetic lifestyle
What is the likeliest diagnosis when heartburn is the principle symptom?
GORD
How do you differentiate heartburn from cardiac chest pain?
Burning quality
Upward radiation
Association with acid reflux
Occurrence on lying flat or bending forward
What is waterbrash?
Sudden appearance of fluid in the mouth due to reflex salvation as a result of GORD or rarely PUD
How common is dyspepsia?
Affects 80% of the population at some time.
In the majority no functional cause is found
How do you classify dyspepsia?
Clusters of symptoms used to classify
Reflux like dyspepsia = heartburn predominant dyspepsia
Ulcer like dyspepsia = epigastric pain relieved by for or antacids)
Dysmotility like dyspepsia = Nausea, belching, bloating and premature satiety
What is the classical symptom of PU?
Dyspepsia that is worse with an empty stomach and is eased by eating
What is odynophagia?
What does it possibly indicate?
Pain on swallowing
Can be present with or without dysphagia.
May indicate active oesophageal ulceration from peptic oesophagi’s or oesophageal candidiasis.
It implies intact mucosal sensation, making oesophageal cancer unlikely
Visceral abdominal pain is conducted via what nerves?
Sympathetic splanchnic nerves
Describe somatic pain
Conducted via intercostal nerves
Pain from the parietal peritoneum and abdominal wall
Where would diverticular pain of the sigmoid colon be felt?
Left iliac fossa
Inflammation may cause localised pain
Sudden onset of severe abdominal pain, rapidly progressing to become generalised and constant suggests what?
What preceding features may you have and what do they suggest?
Hollow viscous perforation
A ruptured abdominal aortic aneurysm
Mesenteric infarction
Preceding constipation suggests CRC or diverticular disease as cause of perforation
Prior dyspepsia suggests peptic ulceration
What does development of circulatory failure following the onset of pain suggest?
Intra-abdominal sepsis or bleeding
e.g. ruptured AAA or ectopic pregnancy
Inflammation and obstruction are the principle pathological processes producing acute abdominal pain.
Describe inflammatory pain
Inflammation usually produces constant pain exacerbated by movement or coughing
What is colicky pain?
Arises from hollow structures e.g. small or large bowel obstruction, or the uterus during labour.
It lasts for a short period of time (seconds or minutes), eases off and then returns “waxes and wanes”
Give examples of radiation in abdominal pain
Pain radiating from right hypochondriac to the shoulder or inter scapular region may reflect diaphragmatic irritation e.g. acute cholecystitis
Pain radiating from the loin to the groin and genetalia = renal colic
Central upper abdominal pain radiating through to back, partially relieved by sitting forward = pancreatitis
Central abdominal pain which later shifts to the RIF = acute appendicitis
The combination of severe back and abdominal pain may indicate a ruptured or dissecting AAA
Abdominal pain persisting for hours or days suggests what?
Inflammatory disorder such as:
- Acute appendicitis
- Cholecystitis
- Diverticulitis
