GI signs and symptoms
- Nausea
-Heartburn/ eipigastric pain
-Loss of appetite
-Abdominal pain
-Unintentional weight loss
-Malabsorption
-Vitamin Deficiency (indicate anaemia) - Change in bowel habit
What is concerning bowel symptoms
- Painful bowel motions
-Blood/ mucus
-Tenesmus (feeling not emptied bowel)
What is GORDS & whats its relevance
Gastroesophageal reflux disease
reflux of acid that damages the upper oesophagus
-NSAIDS, antidepressants, SSRI’s may exacerbate
-Cause Bareetts oesophagus: normal squamous epitelium becomes columnar- dysplasia to adenocarcinoma
What are the risk factors for GORDS
- Obesity (increased intra-abdominal pressure)
-Pregnancy (increased intra-abdominal pressure)
-decreased stomach pH
-alcohol/ fatty acids/ caffein delay emptying of stomach
- reduced tone of lower oeseophageal sphincter
What is a peptic ulcer
Pathological break in the epithelial lining causing inflammation of stomach and duodenum
What are the causes of peptic ulcers
Acids/ enzymes overcome stomach’s natural mechanism of protection
e.g stress,
steroids
NSAIDS
SSRI’s
H.pylori
Alcohol
What are the symptoms of peptic ulcers
- Upper abdominal epigastric pain
- burning in upper abdomen
-Bloatingm
-Heartburn
-Nausea & vomiting
-Dark stool
How are peptic ulcers managed
- confirm diagnosis via upper GI
- Correct risk factors
- Increase stomach pH (PPI’s- less acid produced)
- Eradicate H.pylori (antibiotics: amoxicillin/ metronidazole + clindamycin)
What is irritable bowel disease
Ulcerative colitis/ crohns
- group of conditions causing inflammation of intestines
- differ in location, inflammation, ulceration, variable thickness
What are extra-intestinal effects of IBD
- Fever/ malaise
-Arthritis
-Skin lesions
-Eye lesions
What is ulcerative colitis
starts at anus/ rectum & extends proximally
-NEVER ielum
- affects proxmiaml large bowel
-smoking reduces risk
Diagnosis: colonscopy + biopsy showing mucosa ulceration, inflamamtion, crypt abscesses
What are the signs of ulcerative colitis
Active disease: fever, tachycardia, abdominal distension, clubbing, oral ulceration, arthtitis, conjunctivitis, malabsorption
What are the symptoms of ulcerative colitis
Relapsing/ remiting disease
-diarrhoea
- blood/ mucus in poop
- abdominal pain
What is the tx for ulcerative colitis
Prednisolone
Meslazine (anti-inflammatory)
Sulfasalazine (DMARD anti-rheumartic drug)
What is Crohn’s
Less common
- regional ileitis: colon, small bowel, rectum
- ulceration is deeper (forms stick loops & fistuales)
- unaffected skip lesions
diagnosis: colonscopy+ biopsy showing deep ulcers and granulomatous
What are the signs and symptoms of cronhs
chronic inflammatory disease, diarrhoea, blood mucus
signs: abdominal tenderness, right iliac fossa mass abscess and fistuale, clubbing, skip lesions, eye lesions, arthritis
How is Crohn’s treated
steroids: prednisolone,
anti-infammatories: ,methotrexate
DMARDS:: Mesalazine, sulphasalzine
biological response modifiers: Infliximab
(if monoclonal antibodies are not responding)
What is a polyp
projection growth of tissue in the body
What are the risks of polyps
Develop into cancer:
- abnormal cell growth which has an area of dysplasia can become an invasive adenocarcinomaa
What is meant by adeno
Gland
What are the red flag signs of colorectal cancer
- Change in bowel habit
- Abdominal pain
- Anaemia
- Blood/ mucus in poo
- weight loss
2ww
What should the dentist do if a pt presents with red flag signs of colorectal cancer
2WWW
What is a dentists role in preventing cancer
- Give smoking cessation
-alcohol reduction: Simple 3a’s - Encourage participation in screening
- ASK about symptoms e.g mucous in poo
- Refer to GP
