Category: Gastroenterology

Managing a patient with decompensated liver cirrhosis

Introduction Patients with liver disease are common in the UK. Since 1970, mortality from liver disease has quadrupled. It has become the greatest cause of death in people aged between 35-49 years old1. It is important you know how to manage these patients in the medical take or on general medical wards and are aware

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Gastroenterology in Primary Care

INTRODUCTION This article covers common gastroenterological presenting complaints seen in primary care. Presentations covered are: dyspepsia, diarrhoea, PR bleeding, constipation and deranged LFTs. DYSPEPSIA Definition Spectrum of upper GI symptoms including epigastric pain and heartburn and acid reflux. Can be categorised into functional causes vs. structural causes (e.g. GORD, PUD, GI malignancies) Overview of causes Management

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Chronic Pancreatitis

Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads to the destruction of pancreatic tissue leading to irreversible loss of both endocrine and exocrine function and formation of calcifications, pseudocysts and fibrosis. Risk factors The most common causes of chronic pancreatitis are alcohol and smoking. It is estimated that alcohol causes up to 80%

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Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory disorder of the gastrointestinal (GI) tract, which may be accompanied by extra-GI manifestations. What are the main types of IBD? The term IBD encompasses two types: ulcerative colitis (UC) and Crohn’s disease (CD). CD can affect any part of the GI tract, although in

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Nutrition

Nutrition is an important aspect of a patient’s health and is overlooked during medical school as you are learning exciting pathophysiology of weird and wonderful diseases. One never thinks about nutrition until you are placed on a ward where you need to manage patients in need of nutritional support. Various studies show that doctors and

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Ascitic Tap and Drain

Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent reason to do it would be to consider the diagnosis of spontaneous bacterial peritonitis (SBP). Occasionally a patient may have a therapeutic aspiration where a larger volume is aspirated to relieve pressure if a drain

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Anaemia

Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly see a low haemoglobin & the tendency is to say “haemoglobin stable” and ignore it. However, both acute or chronic anaemia can have a significant impact on health but can also be the presenting sign

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PEG Tubes

PEG tubes are used as long term feeding options (and medication administration) for those in whom NG tubes are unsuitable or too short term. Indications might include head & neck cancers resulting in altered anatomy not allowing a safe swallow or long term neurological conditions (such as MS, stroke, MND) that also impair the patient’s

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Nasogastric Tubes

NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to 6 weeks. However, they quite easily can fall out either being accidentally tugged at night or the tube might get caught. Due to this, they sometimes fall out within a week or two. Wide-bore NGT

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