responding to symptoms 1- gastro-intestinal minor ailments

what are the causes of dyspepsia

Describes a collection of symptoms including:

• upper abdominal discomfort

and pain

• Heartburn

• acid reflux

• nausea and vomiting related to eating

• Non-ulcer dyspepsia- diagnosis made by endoscopy

• GORD

• Peptic ulcer disease- gastric or duodenal

• A hiatus hernia.

what are the signs and symptoms of dyspepsia

Caused when is reflux of gastric contents, particularly acid, into oesophagus, which irritate the sensitive mucosal surface

• Burning discomfort/pain felt in stomach, passing upwards behind the breastbone

• Unpleasant acid taste in the mouth

• Often related to eating

• Other symptoms may include nausea, fullness in the upper

abdomen or belching

what are the referral symptoms of dyspepsia ?

• Gastro-intestinal bleeding

• -‘coffee grounds’ in vomit

• -Black/tarry stools

• Dysphagia (difficulty

swallowing)

• Progressive unintentional

weight loss

• Persistent vomiting

• Severe pain

• Pain radiating to other areas of

body e.g. arm

• Failed treatment

what are the non-prescription treatment options for dyspepsia ?

• Antacids

• Alginates

• Proton pump inhibitors

what is the general advice for gastro-intestinal minor ailments ?

• Dyspepsia:

- Eating smaller, more frequent meals can help

-Raise the head end of your bed, so your chest and head are

above the level of your waist, which can stop stomach acid

travelling up towards your throat

• Smoking- Consider referring the patient into a stop smoking service

• Weight loss

• Avoid trigger foods. E.g. chocolate, alcohol, caffeine, rich/spicy/fatty foods

what is the 1st non-prescription treatment for GI minor ailments ?

Antacids

(e.g. calcium carbonate, magnesium

carbonate)

• Limited evidence on their efficacy

- symptomatic relief often reported

• Best given when symptoms occur or are

expected, ie after meals and at bedtime.

-Remain in stomach for longer at these times,

and therefore have longer to act.

• Should 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

-Aluminium salts alone may cause constipation

what is the 2nd non-prescription treatment for GI minor ailments ?

Alginates-active ingredient

(e.g. sodium alginate, potassium alginate,

Gaviscon)

• Form a ‘raft’ on the stomach contents, providing symptomatic relief of reflux, protecting oesophageal mucosa

• Some products are a combination

of alginates and antacids

• Use potassium based alginates in patients on a restricted sodium diet.

what is the 3rd non-prescription treatment for GI minor ailments ?

Proton pump inhibitors

(e.g. omeprazole, esomeprazole)

• Generally accepted as being the

most effective treatment for

heartburn

• Can take up to 24hrs to become

effective

• Inhibit gastric acid secretion by

blocking the hydrogen potassium

adenosine triphosphatase enzyme

system (the proton pump) of the

gastric parietal cell.

• Licensed for 18 years + for a

maximum of 14 days treatment.

what are the causes of constipation ?

• Poor fibre intake

• Poor fluid intake

• Sedentary lifestyle

• Other medication

what are the signs and symptoms of constipation ?

• Reduced frequency of

defecation compared to what

is normal for that person

• Straining and passage of

small, hard stools

• Abdominal discomfort

• Abdominal cramps

• Feeling of incomplete

emptying of bowels after

going to the toilet