Gastrointestinal Problems 1 0.0 / 5 ? PharmacyPH1122UniversityAll boards Created by: amazingemilyjonesCreated on: 08-04-19 22:20 Gastrointestinal Problems 1 Gastrointestinal Problems 1 1 of 12 Mouth Ulcers Aphthous ulcers small, round or ovoid oral ulcers with well-defined margins Typically first present in childhood adolescence Minor aphthous ulcers Up to 5mm in diameter Appear in small groups (6 at a time) Heal in 7-10 days Major aphthous ulcers Around 1cm in diameter Occur in groups of up to 6 at a time Heal slowly in 10-40 days and often leave scarring 2 of 12 Mouth Ulcers Herpetiform aphthous ulcers (uncommon) Present as multiple pinhead sized discrete ulcers that increase in size and coalesce leaving large area of ulceration Often extremely painful Heal in 10 days or longer May recur frequently so that ulceration seems continuous 3 of 12 Mouth Ulcers: Possible Causes Genetic predisposition - positive family history in up to 40% Smoking cessation Iron, folic acid or vitamin B12 deficiency Hormonal factors - in some women ulcers coincide with (after ovulation) luteal phase of menstrual cycle Local trauma Anxiety Exposure to certain foods, e.g. chocolate, coffee, peanuts and/or gluten products Medication, e.g. Nicorandil, oral NSAIDs, oral nicotine replacement therapy 4 of 12 Mouth Ulcers: When to Refer Duration longer than 3 weeks - rule out oral malignancy Other unexplained gastrointestinal symptoms Immunodeficiency Medication related, e.g. carbimazole 5 of 12 Mouth Ulcers: Management Dentist Chlorhexidine mouthwash Hydrocortisone oromuscosal tablets Local analgesics Local anaesthetics Saline mouthwash 6 of 12 Cold Sores Infection caused by Herpes Simplex Virus (HSV1) Estimated more than 50% adults in Western world have been infected with HSV1 Around 20-50% of people will experience a cold sore at some time Symptoms Prodromal symptoms of itching, burning, tingling pain Occur a few hours to a couple of days before lesion Lesion appears as blister and associated redness These crust over within 24 hours Resolve in 7-10 days 7 of 12 Cold Sores: Trigger Factors and When to Refer Triggers Stress Ill health Sunlight Viral infection, e.g. cold Refer Over 14 days duration Cold sores located within the mouth Severe and widespread lesions Immunocompromised patients Lesions that spread from the lips to the face 8 of 12 Cold Sores: Management Antivirals Aciclovir - applied 5 x daily for 5 days Peniciclovir - applied 8 x daily for 5 days Both applied during prodromal phase Ammonia and Phenol (Blistex) Urea (Cymex) 9 of 12 Heartburn More common in patients over 55 Not normally experienced in childhood Symptoms Burning discomfort experienced in the upper part of the stomach Aggravating factors Bending or lying down Obesity After a large meal Medication related Alpha blockers, anticholinergics, NSAIDs, nitrates, theophyllines and tricyclic antidepressants 10 of 12 Heartburn: When to Refer ALARM symptoms Anaemia Loss of weight Anorexia Recent onset of progressive symptoms Melaenia, dysphagia and haematemesis (blood in faeces, difficulty swallowing, vomiting blood) Severe pain Persistent vomiting Pain radiating to arm, neck and jaw Failure to respond to antacids - 1 week 11 of 12 Heartburn: Management Antacids - neutralise acid - rennie, pepcid Alginates - raft formin - Gaviscon Advance H2 antagonists - ranitidine Proton Pump Inhibitors - most effective Advice Food - small meals eaten frequently Weight reduction Posture - bending, stooping and slumping should be avoided 12 of 12
Comments
No comments have yet been made