GI system

Question 1

What are the urgent referral criteria for upper GI cancer?

Answer 1

• All pts with dysphagia
• Upper abdo mass consistent with stomach cancer
• those aged =>55yrs who have weight loss AND any of:
  a) reflux
  b) upper abdo pain
  c) dyspepsia

Question 2

What are the ‘non-urgent’ referral criteria for endoscopy (upper GI)?

Answer 2

• haematemesis
• pts aged =>55 yrs who have:
  a) treatment-resistant dyspepsia OR
  b) upper abdo pain with low Hb OR
  c) raised plt with any of: nausea, vomiting, weight loss.
  d) Nausea or vomiting with any of: weight loss, reflux, dyspepsia, upper abdo pain.

Question 3

Which food are okay for coeliac disease?

Answer 3

some notable foods which are gluten-free:

• rice
• potato
• corn

food that contain gluten:

• wheat: bread, pasta, pastry
• barley: beer (but whisky is okay).
• Rye
• Oats - some coeliac pts can tolerate oat.

Question 4

Which immunisations are recommended for coeliac patients?

Answer 4

• coeliac patients have some degree of functional hyposplenism.
• they should be given pneumococcal vaccine with a booster every 5 yrs.
• influenza vaccine are given on individual basis.