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referrals from primary care to Gastroenterology in last 2/52.
Pathways vary around the country - nevertheless I have observations / advice about managing common GI problems in primary care & when to refer in
tweets
#GastroTwearls 1/7
referrals from primary care to Gastroenterology in last 2/52.Pathways vary around the country - nevertheless I have observations / advice about managing common GI problems in primary care & when to refer in
tweets#GastroTwearls 1/7
Simple GORD does not need an OGD. This is as per national guidance as OGDs aren’t pleasant & rarely changes management.
See #GastroTwearl
When giving a PPI, Omeprazole is better than Lansoprazole (fewer SEs) - give a decent dose of 40 mg / day
2/7 https://twitter.com/ukgastrodr/status/1273736516108537860
See #GastroTwearl
When giving a PPI, Omeprazole is better than Lansoprazole (fewer SEs) - give a decent dose of 40 mg / day
2/7 https://twitter.com/ukgastrodr/status/1273736516108537860
Constipation is really common & poorly recognised. Often a symptom of IBS.
Opioids are a major culprit and cause much misery - give concomitant laxatives.
See #GastroTwearl below for a
tweet guide.
3/7 https://twitter.com/ukgastrodr/status/1355967547548594176
Opioids are a major culprit and cause much misery - give concomitant laxatives.
See #GastroTwearl below for a
tweet guide.3/7 https://twitter.com/ukgastrodr/status/1355967547548594176
Chronic diarrhoea
Look at medication as a cause.
Often a symptom of IBS
Consider IBD (check faecal calprotectin) & flag cases up
We don’t want to miss or see pts with IBD late
Consider BAM
Don’t forget coeliac disease is common (1%) see #GastroTwearl below
4/7 https://twitter.com/ukgastrodr/status/1370786142761717761
Look at medication as a cause.Often a symptom of IBS
Consider IBD (check faecal calprotectin) & flag cases up
We don’t want to miss or see pts with IBD lateConsider BAM
Don’t forget coeliac disease is common (1%) see #GastroTwearl
below4/7 https://twitter.com/ukgastrodr/status/1370786142761717761
Liver disease causes much consternation. It is under-recognised & is common due to excessive alcohol consumption 
& metabolic conditions causing liver disease.
See #GastroTwearls below with links for abnormal LFTs & jaundice.
5/7 https://twitter.com/ukgastrodr/status/1388563767944941571
& metabolic conditions causing liver disease.See #GastroTwearls below with links for abnormal LFTs & jaundice.
5/7 https://twitter.com/ukgastrodr/status/1388563767944941571
And how can we forget about iron deficiency anaemia? 
See #GastroTwearl below
Also remember that when given iron tablets - 𝗻𝗼 𝗺𝗼𝗿𝗲 𝘁𝗵𝗮𝗻
𝗽𝗲𝗿 𝗱𝗮𝘆!
6/7 https://twitter.com/ukgastrodr/status/1322543496977403905
See #GastroTwearl below
Also remember that when given iron tablets - 𝗻𝗼 𝗺𝗼𝗿𝗲 𝘁𝗵𝗮𝗻
𝗽𝗲𝗿 𝗱𝗮𝘆! 6/7 https://twitter.com/ukgastrodr/status/1322543496977403905
Finally...
Abdo pain - CT scan
is a good test so consider if cause not obvious.
Weight loss is a serious complaint, see #GastroTwearl
Communication is
so if concerned /unsure, discuss with your friendly Gastroenterology & Hepatology teams via A&G, 
or email 
7/7 https://twitter.com/ukgastrodr/status/1334774418833367040
Abdo pain - CT scan
is a good test so consider if cause not obvious.Weight loss is a serious complaint, see #GastroTwearlCommunication is
so if concerned /unsure, discuss with your friendly Gastroenterology & Hepatology teams via A&G, or email 7/7 https://twitter.com/ukgastrodr/status/1334774418833367040
Thank you for reading!
Please share.
Please ask questions & discuss.
Let me know your views
For more #GastroTwearls click the link
https://twitter.com/ukgastrodr/status/1336411189052575751?s=21
Check out http://myEndoscopy.co.uk for patient info on endoscopy procedures
Please share.
Please ask questions & discuss.
Let me know your views
For more #GastroTwearls click the link
https://twitter.com/ukgastrodr/status/1336411189052575751?s=21
Check out http://myEndoscopy.co.uk for patient info on endoscopy procedures
