Wk 11: OTC GI (IBS, Constipation, haemorrhoids, N+V, diarrhoea) Flashcards
What are the symptoms of IBS?
- Bloating
- Alternating constipation/diarrhoea
- Abdominal pain
- Rectal fullness
- Incomplete evacuation
- Nausea, back pain, urinary freq.
When should IBS treatment be offered?
If condition previously diagnosed by Dr
What is given for constipation in IBS?
Anti-spasmodic: relaxes intestinal smooth muscles
- Mebeverine
- Hyoscine butylbromide
- Peppermint oil
CI: paralytic ileus
What is given for diarrhoea in IBS?
- Loperamide
- Dec bowel motility + stool freq.
What is given for both constipation + diarrhoea in IBS?
Ispaghula husk
What are the counselling points for IBS?
- Record triggers
- Don’t rush meals
- Balanced diet w/ fluids
- Regular exercise
- Relaxation
When should a patient be referred when suffering from IBS?
- > 2wks
- Blood ins tool
- Not diagnosed by dr
- Fever
- Unexplained weight loss
What are the causes of constipation?
- Change in eating habit
- Red fluid
- Lack exercise
- Depression
- Pregnancy
- Refuse urge to pass stool
What is the 1st line treatment for constipation?
Alter diet + lifestyle + inc fluid
Give an example of a bulk forming laxative
- Ispaghula husk
- 24-72 hrs
- Not before bed/frail elderly
Give examples of stimulant laxatives
Stim nerve endings:
- Senna: 8-12hrs
- Bisacodyl + sodium picosulphate
What is an osmotic laxative?
Retain fluid in bowel so stims peristalsis + form loose stool
Give examples of osmotic laxatives
- Magnesium sulphate/hydroxide: 3hrs
- Lactulose/macrogol: 72hrs
Give an example of a faecal softener
Docusate sodium: 1-3 days
Which laxatives are CI in breastfeeding + pregnant women?
Stimulant
When do you refer a patient suffering from constipation?
- Unable to work
- Children w/ ill symptoms
- Blood in stool
- Severe pain>2 days
- Weight loss
- Diarrhoea
- N+V
What are haemorrhoids?
Varicose dilations of veins in lower part of large intestines/anus - engored w/ blood
What are the causes of haemorrhoids?
- Anal infection
- Sports
- Sitting/standing for long period
- Pregnancy
- Constipation
- Laxative abuse
What are the symptoms of haemorrhoids?
- Itching perianal area
- Can be painful
- Sharp pain on defecation
- Bright red stool
What are the treatment for haemorrhoids?
- Anusol
- Prep H
- Germoloid
+ hydrocortisone
What are the counselling points for haemorroids?
- Hygiene
- Diet
- Avoid straining/ scratching
- Laxatives
- Inc activity
When do you refer someone with haemorrhoids?
- > 3wks
- Internal anal pain
- Rectal bleed
- Drug induced constipation
- Recurrent piles
What are the causes of nausea + vomiting?
- Viral/bacterial
- Inner ear disorder
- Migraine
- Motion sickness
- Meningitis
- Digoxin, theophylline, NSAIDs
What are the counselling points for nausea + vomiting?
- Offer electrolyte replacement
- Sip little water often
- Avoid dairy/greasy food 24 hrs
What are the counselling points for a pregnant woman with morning sickness?
- Frequent small meals
- Ginger
- Sea bands
When do you refer someone with nausea + vomiting?
- Projectile
- W/ blood
- Weight loss
- babies <12months + symptoms >24hrs
- <3yrs + elderly + symptoms > 48hrs
- Diabetic
What are the causes of diarrhoea?
- Bacterial/viral
- Food allergies
- Diet change
- Stress
- IBS, Diabetes, hyperthyroidism
What can be given to someone with diarrhoea?
Oral rehydration sachets:
- Keep 1hr/24hrs if in fridge
- Sip little + often
What are the counselling points for diarrhoea?
- High fluid intake
- Babies: sterilised bottles
When do you refer someone with diarrhoea?
- Weight loss
- Blood in stool
- Persistent mucus in stool
- Symptoms worsen
- Alt di + constipation
When do you refer an elderly with diarrhoea?
- Symptoms >48hrs
- Chronic
- Recurrent
- Fatigue/pain > 2days
