Revision on Gastroenterology

Enough of politic rubbish which is able to make my blood pressure shoot up. Now lets revise on gastroenterology

Common symptoms
abdominal pain or discomfort
Bloating
Nausea and Vomiting
Diarrhea


There are hundreds cause of abdominal pain from abdominal trauma to carcinoma of the innards. It is easier to group together the site of the pain to point to the problematic organ. Therefore, there are upper,mid and lower abdomninal pain. Upper abdominal pain mostly is due to problem in the stomach, liver, bile duct,duodenum or pancreas. Mid abdominal pain often due to small intestine and lower abdominal pain is due to large intestines or the reproductive organs.

Question
How to differentiate between a visceral pain and a musculoskeletal pain(abdominal wall pain) in the abdomen clinically(From physical examination)? Not from Hx, not radiologically and not from any investigation.
I will provide the answers only if anyone care to know or try answering... :)
Lau hia, zhen hsiung, i tell u all before, faster answer hahaha :D

Bloating of the abdomen can be due to massive ascites and overproduction of gas by the intestinal flora.
Easy question : How to differentiate by physical examination?

What makes overproduction of gas happen? Food (lactose intolerant individual) and overgrowth of intestinal flora due to stasis of the intestine can cause it.

Question
Sometimes patient complain of feeling bloated in the abdomen when there are no overproduction of gas or ascites. what do you think makes them feel that way? Hint : hypersensitive?

Nausea and vomiting- again there are so many causes. so just classify them into GI and non GI cause. GI causes : Infection,obstruction, inflammation Non GI cause : Neurological e.g. motion sickness, increased ICP, Drug induced e.g. alcohol,opiates,digoxin, hepatobiliary disease, UTI, pregnancy.

So when asking bout vomiting ask for the timing, the volume, the content of the vomitus.

Question
Name 2 infectious agent that cause vomiting but no diarrhea

Diarrhea.......bermacam diarrhea.
Secretory diarrhea- too much excretion of fluid into bowel. Caused by infection, neoplasm,endocrine cause e.g. carcinoid and Z-E syndrome)

Osmotic diarrhea-the more you eat, the more the diarhea is. If you fast it disappear.
Question: What's the most common cause?

Exudative diarrhea occur if there is inflammation of large bowel. Small amount but frequent and may be bloody or mucoid. Common cause is infection(Shigellosis and amoebiasis), IBD and Malignancy

other special types such as fatty stool (Steatorrhea...correct spelling rite?) may be cause by bile deficiency due to obstrution or terminal ileum damage or drugs.

Question : Why is there diarrhea alternating with constipation in patient with colon cancer?
What is peptic ulcer disease? What cause it? Presenting symptoms?
What is the triple therapy for peptic ulcer disease caused by the bacteria?

How do you manage hepatitis B and hepatitis C patients?

What are the complications of hepatitis?

Differences between Crohn's and UC?

Complications of IBD

What is functional dyspepsia and how to manage?

sounds fun hor....look it out la if free nothing to do..