List come causes of abdominal pain
- Gastric pain- NSAIDs
- Constipation- Iron, Opioid, TCAs
- Oesophageal ulceration- potassium chloride, alendronic acid, doxycycline
Refferal Points for abdominal pain
- Continuous sever pain for >1hr
- babies
- lasting more than 1 week
Give causes of Indigestion
- Spicy foods
- Smoking
- H.Pylori
- Heart failure
- Overweight
- Pregnancy
- Medications
Symptoms of indigetion
- Heartburn
- Epigastric discomfort shortly after eating/drinking
- Feeling of fullness
- Flatulence*
- Nausea/vomiting*
List treatment for Indigestion
- Antacid (Milk of magnesia)
- Alignates (Gaviscon)
- H2RA (Ranatidine)
- PPI (esomeprazole)
Refferal for indigestion
Over 55 years with alarm signs or persistent symptoms:
List the ALARMS
- Anemia
- Loss of weight
- Alternating bowel movement
- Red bloods
- Mass or Lumps
- Swallowing difficulties
Causes of constipation
- Lifestyle; diet, fluid and exercise
- Medication; opiates, iron
- conditions; pregnancy, depression and IBS
List treatment and counsel on usage
- Bulk; Isphagula Husk
- Stimulant; Biocodyl
- Osmotic; Lactulose
- Faecal Softner; Dousate Sodium
- Glyerin
Referral for Constipation
- Unable to work
- Fever
- > 2days
- No reilef after treatment
- ALARMS
Causes of Nausea/Vomiting
- Toxins
- Inner ear disorders
- migraine
- pregnancy
- medication
Treatment for N/V
Oral rehydration (dioralyte)
Sea bands, ginger, lime
Referral for N/V
- projectile vomiting
- > 6mnths more than 48hrs
- <6mnths more than 24hours
Counselling points for N/V
- small regular meals
- avoid greasy, dairy foods
- start with liquids
Causes of IBS
- Emotion/stress
- Food intolerance
- Unknown (diagnosis by elimination)
Symptoms of IBS
- Young adults: alternating bouts of constipation/diarrhoea, bloating, abdominal pain
- Rectal fullness, incomplete emptying
- Nausea, back pain, frequent urination
Treatment of IBS
Once diagnosed by GP
1. Anti-diarrhoeal: Loperamide (Imodium)
Administration;
18years+ Take TWO initially then 1 after each loose stool. MAX 6/day
- Anti-spasmodic: Peppermint Oil (Colpermin IBS), Mebeverine (Colofac IBS), Hyoscine butylbromide (Buscopan IBS)
Administartion;
12years+ ONE tablet three times a day. Can go up to 2 a day.
- C/I: paralytic ileus
- Bulking Agent: Ispaghula Husk (Fybogel Hi-Fibre)
Counselling for IBS
Try not to rush meals, keep a balanced diet and drink plenty of fluids, regular exercise, attend relaxation classes, ask if taking other medications
Causes of mouth ulcers
- Sometimes unknown
- Trauma (i.e. biting)
- Vitamin deficiency
- Stress
- Physical illness (i.e. Crohn’s)
- Nutrition
- Carcinoma
Symptoms of mouth ulcers
- Shallow white/yellow ulcers on lip, cheek, tongue
- Very painful, can look swollen
- Single/clusters
Treatment of mouth ulcers
- Anbesol; clean finger max every 3hours for 7days
- corsodyl; >12years 10ml BD and 2 days after it resolves
Referral for mouth ulcer
- recurrent
- > 3weeks
- signs of infection
- diabetic
- pregnant/BF
Signs of oral thrush
- White raised patches
- Tendency to bleed
- Can be painful
Causes of oral thrush
- Antibiotics
- Inhaled corticosteroids
- Immunocompromised
- Diabetes
- Pregnancy/contraceptives
- Ill-fitted dentures
