DDX - GIT

Question 1

What are some painful anal diseases associated with chronic constipation?

Answer 1

• Fissure
• Fistula
• Haemorrhoids

These conditions can cause significant discomfort and are often linked to chronic constipation.

Question 2

What type of neoplasm can be a cause of chronic constipation?

Answer 2

Large bowel cancer

Neoplasms can obstruct the bowel, leading to constipation.

Question 3

Name two endocrine/metabolic conditions that can lead to chronic constipation.

Answer 3

• Hypercalcaemia
• Hypothyroidism

These conditions can disrupt normal bowel function.

Question 4

What are two neurological causes of chronic constipation?

Answer 4

• Hirschsprung’s disease
• Spinal cord damage

Neurological issues can affect bowel motility.

Question 5

Name two drug-induced causes of chronic constipation.

Answer 5

• Anticholinergic drugs
• Opiates (such as codeine)

Certain medications can slow down bowel movements.

Question 6

What psychogenic factor is associated with chronic constipation?

Answer 6

Depression

Psychological conditions can impact gastrointestinal function.

Question 7

List some various factors that can contribute to chronic constipation.

Answer 7

• Irritable bowel syndrome
• Low fibre intake
• Old age
• Pregnancy
• Prolonged immobility
• Chronic illness

These factors can all influence bowel health and function.

Question 8

What red flags are associated with GIT?

Answer 8

Bloody stools or bloody diarrhoea;
Diarrhoea associated with severe abdominal pain;
New onset of constipation, or stools that look darker than normal;
Vomiting blood or vomit that looks like coffee grounds;
History of heavy alcohol use;
Vomiting or pain that stops patient from taking your regular medications;
Abdominal pain associated with fever, vomiting, diarrhoea, or lack of appetite;
Abdominal pain that becomes worse after meals;
Abdominal pain in the presence of chronic ibuprofen (or any other NSAID drug) or aspirin use;
Abdominal pain that starts suddenly;
Abdominal pain that doesn’t resolve;
Any of the above symptoms associated with a history of heavy alcohol use.

Question 9

What is the acute abdomen?

Answer 9

Definition

A patient who becomes acutely ill with symptoms and signs relating to the abdomen (abdominal pain, tenderness, nausea, vomiting, etc.) is said to have an “acute abdomen”

Clinical features

The presenting symptoms and signs – together with the results of basic tests – sometimes suggests a firm diagnosis, but it is often surprisingly hard to choose between the following list of possible causes:

“Surgical” cases

Rupture of an organ (e.g., spleen, aorta, ectopic pregnancy)
Perforation of the bowel (from peptic ulcer, appendicitis etc)
Pancreatitis
Local peritonitis (resulting from diverticulitis, appendicitis, cholecystitis, salpingitis)
Colic caused by muscular spasm (of gallbladder, gut, ureter, uterus)
Bowel obstruction

“Medical” cases

Myocardial infarction
Gastroenteritis
Urinary tract infection
Diabetes
Pneumonia
TB
Malaria
Typhoid
Cholera

Answer 10

2. DIARRHOEA
   Infective:

        Amoebae
        Salmonella
        Shigella
        Staphylococcus
        Vibrio Inflammatory:
   
        Crohn’s disease
        Ulcerative colitis Malabsorption syndromes (often cause fatty stools that don't flush easily. This is known as steatorrhoea.)

Endocrine and metabolic:

        Diabetic autoimmune neuropathy
        Thyrotoxicosis  Neoplasia: Large bowel carcinoma

Iatrogenic:

Post-antibiotic therapy
After bowel resection
Psychogenic: Anxiety

General: Food intolerance