RTS Gastro-Intestinal System Flashcards

1
Q

Define Dyspepsia

A

A term used to describe a range of symptoms including: - Pain/discomfort in the abdomen - Regurgitation of food or acid re-flux - Nausea and vomiting relating to eating - sour acid taste - fullness, bloating, wind - heartburn

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2
Q

Triggers to dyspepsia

A

Smoking, Eating late near bed time, Alcohol,

NSAIDS, Being overweight Pregnancy

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3
Q

Key conditions in dyspepsia

A

Peptic ulcer disease

GORD, duodenitis, gastritis infection by H.Pylori

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4
Q

Danger symptoms in dyspepsia

A

GI bleeding unintentional weight loss persistent vomiting black ‘tar’ stools cardiac pain (after mistaken for dyspepsia) pain radiating down arm, not relieved by antacids patients above age 45 with first episode ever recurrent

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5
Q

When do you refer for dyspepsia - what drugs??

A

Dyspepsia caused by POM NSAIDS, Iron, corticosteroid

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6
Q

Dyspepsia first line treatments

A

combinations of antacids, to be taken after meals and at bedtime e,g Magnesium and Aluminium Alginate rafts to form a barrier and minimise reflux.

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7
Q

Dyspepsia second line treatments

A

H2 Antagonists e.g ranitidine and famotidine - Inhibit stomach acid production. Short term use. 12 hour relief

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8
Q

Dyspepsia third line treatments

A

Proton pump inhibitors - Omeprazole/Pantoprazole to suppress acid.

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9
Q

Who shouldnt we give ranitidine or omeprazole to?

A

under 16’s (ranitidine) and under 18s (omeprazole) and don’t give it to pregnant/breastfeeding women Or liver/renal impairment

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10
Q

Self care for dyspepsia

A

weight loss, no smoking, avoid trigger foods e.g caffeine/ alcohol/ rich and spicy foods/ take small or regular meals.

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11
Q

What is Nausea?

A

queasy feeling a person gets before being sick or throwing up

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12
Q

Define vomiting?

A

body’s way of getting rid of stomach contents it feels may be causing harm

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13
Q

Internal causes of nausea and vomiting

A

headaches, viral infections, pregnancy, severe pain, heart attacks

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14
Q

External causes of nausea and vomiting

A

motion sickness, alcohol poisoning, food poisoning, medicines

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15
Q

Other causes of nausea and vomiting not so common?

A

Allergy, Stress, cancer, overeating

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16
Q

Nauseas and vomiting - when do you refer?

A

Pregnant women. Dehydrated following ORT. Food poisoning, e.g E.coli. Infant/Child <6 Not urinated in last 6 hours.

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17
Q

what calls for urgent referral where you might want to give Dr an added note

A

Blood in vomit (bright red or looks like ‘coffee grounds’) Severe headache or stiff neck Lethargy, confusion or decreased alertness Rapid breathing or pulse

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18
Q

Drug treatments for nausea

A

Prochlorperazine, buclizine ( for migrane and for Prochlorperazine vomiting) Promethazine, Cinnarizine, Hyoscine (travel sickness) Bismuth subsalicylate (nausea due to dyspepsia)

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19
Q

Treatment for pregnant women with travel sickness or morning sickness in pregnancy

A

Accupressure bands

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20
Q

Nausea and vomiting self care

A

Small frequent sips of water, small meals if possible, rest and ginger tea/biscuits

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21
Q

what do you want to do at the end of any consultation?

A

make recommendations on websites such as nhs choices and patient.co.uk. As patient if they understand, and if they have any questions, where they should go

22
Q

Define GORD

A

unpleasant burning feeling felt behind breastbone, accompanied by a sour or bitter taste in the throat caused by reflux or GI contents into the oesophagus

23
Q

what actually causes heart burn?

A

The gullet does not have a protective lining, and so it becomes sore and inflamed when acid rises up from the stomach

24
Q

Common symptoms of GORD

A

Burping, A sour acid taste in back of throat. Discomfort that gets worse after eating, lying down or bending over. Bloating. Burning feeling in chest! and pain behind breastbone.

25
Q

GORD in infants what do they present with? why do they get GORD?

A

children may present with recurrent vomiting. There is a passive transfer of gastric contents to oesophagus

26
Q

How long does it take for GORD to be resolved in infants? What can you say to a worried mother about GORD?

A

12-18 months. Half of babies below 3 months bring up food at least once/day!

27
Q

How to treat a non-ulcer dyspepsia

A

Can treat with H2 antagonists or PPI

28
Q

what is PUD?

A

Two types: Gastric and Duodenal. Erosion of the stomach lining, often due to overproduction of acid.

29
Q

What is IBS?

A

Abdominal pain or discomfort accompanied by changes in bowel habits for the past 6 months. Sx may worsen by eating

30
Q

IBS Treatments

A

Bulk-forming laxative e.g isphagula for constipation Anti-diarrhoeals, e.g loperamide Antispasmodics e.g mebeverine, or hyoscine (abdominal pain) Peppermint oil - direct relaxant on smooth intestinal muscle Antiflatulents e.g simeticone to relieve wind pain and bloating

31
Q

IBS Self care

A

Exercise Diet Fibre, adequate fluid intake, low fat and cut out processed foods. Monitor triggers e.g foods,stress, hormonal Quit smoking

32
Q

What is constipation?

A

Infrequent bowel movement with a sensation of pain and incomplete evacuation. Accompanied by straining and passage of hard stools.

33
Q

Who defines constipation?

A

The patient. What is normal

34
Q

Prevalence of constipation

A

increases with ages, and affects more women than men. Pregnancy (up to 38%)

35
Q

what causes constipation? (non drug)

A

poor fibre intake, diet, water, pregnancy?

36
Q

what drugs cause constipation

A

OPIOID USE, Diuretics, long term laxative use, IBS, cancer, iron supplements, antacids containing aluminium

37
Q

when to refer a constipated patient?

A

new or worsening symptoms, weight loss, blood in stools, nausea and vomiting. major change in bowel habit.

38
Q

with opioid induced constipation what laxatives do we avoid?

A

osmotic and stimulant laxatives

39
Q

Self care constipation

A

Diet - plenty of fruit and vegetables. Increased fluid consumption Regular exercise Avoid holding the urge

40
Q

What is Diarrhoea

A

Frequent bowel movements of a more watery consistency with a sensation of URGENCY

41
Q

what accompanies diarrhoea frequently?

A

vomiting and headache

42
Q

on the physiological level, why does diarrhoea occur?

A

the lining of the large intestine becomes inflamed preventing fluid absorption from food in the intestine

43
Q

Acute Diarrhoea

A

comes on suddenly and lasts 5-10 days due to viral infection e.g norovirus or bacterial infection e.g E.Coli, Salmonella or parasitic. Infected water “traveller’s diarrhoea” Stress or anxiety, Alcohol/Coffee

44
Q

What medications can cause diarrhoea

A

broad spectrum abx and antacids containing magnesium

45
Q

Chronic Diarrhoea. How long does is last and what can cause it

A

lasts more than 2 weeks and can also be caused by bacterial or viral infections. Poor diet and overuse of laxatives can be a factor.

46
Q

Long terms conditions associated with Diarrhoea

A

IBS, lactose intolerance, ulceration colitis

47
Q

When to refer a patient with diarrhoea?

A

drowsiness or confusion. passing little urine more than 3 days in adults more than 24 hours in children under 12, and elderly. dehydration and sunken eyes. Fever and Patient has been abroad

48
Q

Danger symptoms of diarrhoea to signpost

A

bloody, black, mucus stool

49
Q

Treatment of Diarrhoea

A

ORT e.g Dioralyte. Reconstitute with fresh water. Antidiarrhoeals e.g Loperamide. Slow down passage of food.

50
Q

Diarrhoea and constipation self care

A

Good food hygiene, wash hands, clean and disinfect toilet

51
Q

Diarrhoea self care specifics

A

Drink water regularly, rest. BRAD Diet. Bannas, rice, apples, dry toast. No need to avoid solid food!

52
Q

What might we also consider for patients who had abx therapy and are having diarrhoea

A

probiotics!