GASTRO INTESTINAL

See also

Parasites

Common problems

• Acid reflux / heartburn: Worse after large meals, often worse when lying flat.
• Gastritis / duodenitis: Pain before and / or after meals.
• Peptic ulcers: Generally more severe pain with or without signs of bleeding into the gut - see "danger signs" below.
• Gall stones: Dyspepsia and flatulence and fat intolerance, especially in older patient.
• Drug induced: Especially NSAID and aspirin.

Danger signs

• Vomiting blood. Contact GP urgently.
• Vomiting old blood - looks like coffee grounds. Contact GP urgently.
• Age over 40 with persistent symptoms. Contact GP.
• Black tarry stools - melaena. Contact GP urgently.
• Weight loss.Contact GP.

Notes for children

• Contact GP - unless quickly resolves with an antacid.

Notes for the elderly

• Acid reflux - with a clear history - can be treated long-term otherwiseContact GP. Prone to NSAID induced dyspepsia. Stop NSAID - or add concurrent acid blocker.

General advice

• Avoid smoking - aid cessation as matter of priority.
• Reduce stress.
• Consider dietary advice eg: alcohol, spicy foods.

Therapy

• Antacid therapy.
• H2 receptor blocking drugs.

Dictionary

Dyspepsia: gastric indigestion.
Gastritis: inflamation, especially mucosal, of the stomiach.
Melaena: passage of dark coloured, tarry stools, due the presence of blood altered by the intestinal juices.
Peptic ulcer: an ulcer of the alimenta mucosa, usually in the stomach or duodenum, exposed to acid secretion.

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