Lecture 12 - Treatment of minor ailments in GI Tract

Question 1

Causes of Diarrhoea

Answer 1

failure of LI to reabsorb water (could be due to inflammation)

Question 2

Safety netting

Answer 2

letting patient know what to do next if a treatment doesn’t end up working for them

Question 3

Why can acute diarrhoea be catastrophic to health?

Answer 3

due to dehydration and subsequent loss of electrolytes. Potassium especially because there isn’t much of it in the body compared to other ions, so small changes in these levels can cause issues.

Question 4

Treatment for Diarrhoea

Answer 4

-drinking fluids
-rehydration drinks
-antidiarrheals (loperamide) although not preferred treatment, slows transit time through GI.

Question 5

Warning signs in diarrhoea

Answer 5

-blood/mucus (ok in small quantities
-black stools (indicate bleeding in upper GI)
-dehydration, lethargy, headaches, dry mouth
-if it lasts over 5 days
-vomiting for more than a day
-changes in bowel habit or travel abroad

Question 6

Symptoms of constipation

Answer 6

-stomach cramps/bloating
-unusually hard, lumpy of difficult to pass

Question 7

Causes of constipation

Answer 7

-chronic problems - haemorrhoids, faecal impaction
-dietary problems (lack of fibre/fluids)
-lack of mobility (older people especially)
-medication (strong analgesics, antidepressants, antiepileptics, iron supplements)
-pregnancy
-medical conditions (diabetes, Parkinson’s, underactive thyroid)

Question 8

Treatment of constipation

Answer 8

-increasing fibre in diet
-stimulant laxatives
-osmotic laxatives
-bulk-forming laxatives

Question 9

Stimulant laxatives

Answer 9

-increase intestinal activity (taking 8-12 hrs) and can cause cramps, fluid loss, electrolyte imbalance

Question 10

Osmotic laxatives

Answer 10

retain fluid in bowel via osmosis. Patients must drink plenty for this to work. Drug of choice for people on opioids who are suffering from constipation. Takes up to 3 days to work. Can cause flatulence, abdominal pain, colic

Question 11

Examples of osmotic laxatives

Answer 11

lactulose, magnesium salts. movicol (must be dissolved)

Question 12

Bulk-forming laxatives

Answer 12

-stimulate peristalsis
-takes 24-36 hrs to work
-important to drink water to avoid impaction
-can cause flatulence + abdominal bloating
-NEVER UXSE IN OPIOID INDUCED CONSTIPATION

Question 13

What laxative should you NEVER USE IN OPIOID INDUCED CONSTIPATION

Answer 13

bulk-forming laxatives, as it would make constipation worse and increase risk of impaction

Question 14

Warning signs of constipation

Answer 14

-alternating with diarrhoea
-blood/mucus
-weight loss
-laxative abuse
-vomiting
-fever
-angina (caused by straining)

Question 15

What are haemorrhoids?

Answer 15

abnormal swelling/enlargement of anal vascular cushions

Question 16

Symptoms of hemorroides

Answer 16

-bright red blood
-Pruritus (itching)
-soiling
-rectal fullness/anal lump
-thrombose

Question 17

Treating haemorrhoids

Answer 17

-treat constipation
-use bulk-forming laxatives
-creams, ointments and suppositories
-local anaesthetic astringent and barrier cream (anusol - contains lidocaine), sudocrem, hydrocortisone (anti-inflam)