Med B - Dysphagia, dyspepsia and diarrhoea

Question 1

patient is found to have oesophagitis, how should this be treated?

Answer 1

• life style advice

- PPI

Question 2

45 y/o female

pc: bloating and diarrhoea present for a long time

differential diagnoses

Answer 2

1. Irritable bowel syndrome
2. Coeliac’s disease
3. Crohn’s disease
4. colorectal cancer

Question 3

45 y/o female

pc: bloating and diarrhoea present for a long time

what investigations may GP perform and why?

Answer 3

1. FBC - maybe haemantinics = iron, folic acid and b12
2. CRP - inflammation
3. TTG is coeliac suspicious
4. TFTs
5. Calprotectin : low value used to support IBS. not reccomended in older patients due to risk of missing serious pathology such as cancer

Calprotectin is a protein biomarker that is present in the faeces when intestinal inflammation occurs

Question 4

how would you explain diagnosis of coeliacs disease to this patient?

Answer 4

• body reacting to gluten (component of wheat)
• leads to subtle damage and inflammation of small bowel
• reduced surface area for absorption
• fatigue, anaemia (low iron and or folic acid)