Diagnosis and management - lower GI

causes of constipation

poor diet

low fluid intake

reducded mobility

drugs

ALARM

Aneamia

loss of weight

Anorexia

Recent onset

Melaena

Management for constipation

1st line - lifestyle

2nd line - laxatives

whats the laxative stepwsie approach

1. bulk forming - fybogel

2. osmotic laxactives - macrogol

3. stool softeners - Docusate

4. stimulant laxatives - senna

causes of diarrhoea

bacteria

viruises

protozoa

drugs

Referal symptoms for Diarrheoa

blood in stools

partient unable to drink fluids

weight loss

recent hosptial stay

Recent antibitoic use

Diarrhoea treatment

1st - rehydrate ORT

2nd - anti-motility drugs eg lopermide

advice for diarrhoea

drink plenty of fluids

avoid very surgary drinks

avoid milk and milky drinks

hygiene

commone symptoms of heamorrhoids

bleeding on tissue paper

pain

itching

treatment of heamorrhoids

pain relief

antistringents

antiinflammatories

IBS referal symptoms

weight loss

rectal bleeding

recent change in bowel habit

presistant or frequent bloating in females

abdominal or rectal mass

family history

IBS treatment

outside of competency

possibly antispasmoidics

referal for constipation

ALARM

Treatment failure

suspected faecal impaction

suspected anal fistula

undiagonsed haemorhoirds

referal for haemorrhoids

unintentional weight loss

rectal bleeding

recent changes in bowel habit

persistent or frequent bloating in females

abdominal or rectal mass

family history