RTS – Gastrointestinal System

What is the definition of constipation according to NICE?

"Infrequent bowel movement with a sensation of pain and incomplete evacuation, often accompanied by straining and the passage of small, hard stools."

What is considered normal bowel habits per NICE and Rome IV classification?

"Passing stools between three times a day and three times a week."

What are common causes of constipation?

"Poor fibre intake, inadequate water consumption, sedentary lifestyle, pregnancy, medications (e.g., codeine, antacids with aluminum, iron supplements), IBS, or cancer."

What are red flag symptoms for constipation that may suggest colorectal cancer?

"New or worsening symptoms, weight loss, fatigue, blood in stools (red or black), age over 40 with major change in bowel habit."

What is the first-line treatment for constipation?

"Bulk-forming laxatives (e.g., ispaghula husk, bran) to increase stool mass, taken with plenty of water, effective within 24-36 hours."

What are the symptoms of bowel cancer that require urgent medical attention?

"Blood in poo or from the bottom, obvious change in bowel habit, unexplained weight loss, extreme tiredness, lump or pain in the tummy."

What is the lifetime risk of developing bowel cancer for men and women?

"1 in 15 for men and 1 in 18 for women."

What is the primary treatment for diarrhoea to prevent dehydration?

"Oral rehydration therapy (ORT) with solutions containing water, salts, and sugar."

What is Enterosgel used for in the treatment of diarrhoea?

"Binds to bacterial toxins and harmful substances, expelling them via stool, effective for acute diarrhoea and IBS with diarrhoea."

What are the diagnostic criteria for IBS according to NICE?

"At least 6 months of abdominal pain or discomfort relieved by defecation or associated with altered bowel frequency/stool form, plus two of: altered stool passage, abdominal bloating, symptoms worse with eating, or passage of mucus."

What are treatment options for IBS with constipation?

"Bulk-forming laxatives (e.g., ispaghula) to relieve constipation."

What are treatment options for IBS with diarrhoea?

"Anti-diarrhoeals (e.g., loperamide) to reduce bowel frequency."

What is the definition of nausea?

"A queasy feeling a person gets before being sick or throwing up."

What are urgent referral symptoms for nausea and vomiting?

"Blood in vomit, severe headache or stiff neck, lethargy/confusion, severe abdominal pain, temperature above 40°C, rapid breathing or pulse."

What are threadworms, and what is their scientific name?

"Small parasitic worms known as Enterobius vermicularis that infect the intestines."

What is the treatment for threadworms?

"Anthelmintics (e.g., mebendazole 100 mg), with a second dose after 2 weeks if infection persists, and treatment for the whole family."

What are haemorrhoids, and where are they located?

"Swellings containing enlarged blood vessels found inside or around the rectum and anus."

What are symptoms of haemorrhoids?

"Anal itch, bright red blood after passing a stool, lump hanging down from anus, soreness/redness/swelling around anus, sensation of incomplete defecation."

What is dyspepsia, and what symptoms does it include?

"A range of symptoms including pain/discomfort in the upper abdomen, regurgitation, nausea/vomiting related to eating, sour/acid taste, fullness, bloating, wind, and heartburn."

What are danger symptoms for dyspepsia requiring referral?

"GI bleeding (bright red or 'coffee grounds' vomit), dysphagia, unintentional weight loss, persistent vomiting, black 'tar' stools."

What is the definition of GORD?

"Unpleasant burning feeling behind the breastbone (heartburn) with a sour or bitter taste in the throat caused by reflux of GI contents into the oesophagus."

What are potential complications of untreated GORD?

"Oesophageal stricture, Barrett's oesophagus, or oesophageal cancer."

What is non-ulcer dyspepsia (NUD)?

"Recurring bouts of dyspepsia with normal endoscopy results, also known as functional or idiopathic dyspepsia."

What is peptic ulcer disease (PUD)?

"Gastric or duodenal ulcers confirmed by endoscopy, describing a breach in the epithelium of the gastric or duodenal mucosa."