1 / 70

Taking a Gastrointestinal History

Taking a Gastrointestinal History. Dr. J.A. Coetser Department of Internal Medicine CoetserJA @ ufs.ac.za. Major symptoms. Abdominal pain Appetite and/or weight change Postprandial fullness or early satiation Nausea and vomiting Heartburn and/or acid regurgitation Waterbrash

thyra
Download Presentation

Taking a Gastrointestinal History

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Taking a Gastrointestinal History Dr. J.A. Coetser Department of Internal Medicine CoetserJA @ufs.ac.za

  2. Major symptoms Abdominal pain Appetite and/or weight change Postprandial fullness or early satiation Nausea and vomiting Heartburn and/or acid regurgitation Waterbrash Dysphagia Odynophagia Diarrhoea Constipation

  3. Bloating • Bleeding • Haematemesis • Melena • Haematochezia • Jaundice • Dark urine, pale stools • Pruritis • Lethargy • Fever

  4. SOCRATES • Site • Onset • Character • Radiation • Alleviating factors • Timing • Exacerbating factors • Severity

  5. Activity 1: Gastroesophageal reflux disease

  6. GERD Site? RETROSTERNAL

  7. GERD Onset and timing BENDING OVER AND LYING DOWN

  8. GERD Character BURNING BITTER / SOUR FLUID IN MOUTH

  9. GERD Radiation TO NECK

  10. GERD Alleviating factors ANTACIDS

  11. GERD Exacerbating factors

  12. Activity 2: Peptic ulcer disease

  13. PUD Site EPIGASTRIC

  14. PUD Onset and timing MEALS GASTRIC ULCER = WORSENS DUODENAL ULCER = IMPROVES

  15. PUD Character BURNING DULL

  16. PUD Radiation TO BACK

  17. PUD Alleviating factors ANTACIDS

  18. PUD Exacerbating factors OFTEN SPICY FOOD, NSAIDs

  19. Activity 3: Bleeding from peptic ulcer disease

  20. PUD • RISK FACTORS? • NSAIDs • Alcohol • Smoking • H. pylori infection • Stress

  21. PUD • Stool changes MELENA • Vomitus COFFEE-GROUND

  22. PUD Vomitus RED BLOOD

  23. Activity 4: Pancreatic disease

  24. Pancreatic disease Site EPIGASTRIC

  25. Pancreatic disease Onset and timing PAIN WITH MEALS

  26. Pancreatic disease Character DULL, STEADY

  27. Pancreatic disease Radiation TO BACK

  28. Pancreatic disease Alleviating factors

  29. Pancreatic disease Exacerbating factors MEALS ALCOHOL LYING DOWN

  30. Activity 5: Biliary disease

  31. Biliary disease Site EPIGASTRIUM = COMMON BILE DUCT RIGHT HYPOCHONDRIUM = CYSTIC DUCT

  32. Biliary disease Onset ACUTE EPISODES OF RECURRING PAIN

  33. Biliary disease Character USUALLY SEVERE, CONSTANT, LASTS FOR HOURS CAN BE COLICKY

  34. Biliary disease Radiation RIGHT SHOULDER

  35. Activity 6: Renal calculi

  36. Renal calculi Site FLANKS RENAL ANGLE

  37. Renal calculi Onset and timing ACUTE

  38. Renal calcul Character SEVERE, COLICKY PAIN

  39. Renal calculi Radiation GROIN

  40. Renal calcul Alleviating factors ROLLING AROUND OFTEN IMPROVES PAIN

  41. Activity 7: Bowel obstruction

  42. Bowel obstruction Site and radiation SMALL BOWEL = UMBILICUS LARGE BOWEL = NON-SPECIFIC

More Related