OTC

Question 1

DYSPEPSIA:

• What is it?
• What are the danger symptoms?
• Differential diagnosis?
• Treatment options?

Answer 1

• It is a collection of symptoms include upper abdominal discomfort and pain, heartburn, acid reflux, N+V related to eating

Question 2

Dyspepsia

What are the danger symptoms?

Answer 2

• Danger symptoms –>
• GI bleeding (coffee grounds in vomit)
• Dysphagia
• Progressive unintentional weight loss
• Persistent vomiting
• Iron deficiency anaemia

Question 3

Dyspepsia:

Differential diagnosis

Answer 3

Differential diagnosis:
Cardiac pain, pain travelling down the arm (not relieved by antacids)
Identify other medicines that are being taken to rule out any adverse effects e.g. NSAIDs

Question 4

Dyspepsia:

Treatment

Answer 4

Treatment:
- Simple Antacids:
–> Limited efficacy
–> Best given when symptoms occur or are expected i.e. after meals and at bedtime
–> Should preferably not be taken at the same time as other drugs as they may impair absorption
–> Combination antacid products, containing both magnesium and aluminium salts are less likely to cause gastro-intestinal upset.
Magnesium salts alone may
cause diarrhoea while aluminium salts alone may cause constipation.

• Alginates-

Question 5

Constipation:

Definition and symptoms:

Answer 5

Constipation is the passage of dry, hard stools less frequently than a person’s usual bowel habit,
which varies from person-to-person

Straining may also cause constipation

Other symptoms–>

• Abdo discomfort
• Bloating
• Cramps
• Nausea
• A feeling of incomplete emptying of the stool

Question 6

Constipation:
Referral Criteria (and red flags)

Answer 6

Adults with new/worsening constipation
accompanied by symptoms of weight loss, appetite loss, blood in stools*, nausea and vomiting - Colorectal cancer

Drug induced constipation: i.e. opioids, hyoscine, verapamil, propranolol, antacids containing aluminium -