HEARTBURN ACID
REGURGITAN
retrosternal area
burning pain / discomfort in t oe
>
-
Sensation typically travels up towards the throat 3 accurs
after meals or is
aggravated by bending stooping ,
or
lying supine T
> antacids
usually relieve the pain
-
> due
-
to regurgitation of stomach contents into the oesophagus
-
usually acidic although occasionally alkaline reflux can
,
induce similar problems
-
acid regurgitation : associated with gastro-oesophageal
reflux in which experiences sour/bitter
, the pt . a
tasting fluid caming up into the mouth
>
strongly suggests that reflux is occuring
-
>
-
some pts Complain of a cough that troubles
. them when L
they lie down
>
-
the lower oesophageal sphincter muscle relaxes
in appropriately
>
symptoms may be aggravated by :
-
-
alcohol
-
chocolate
-
Caffeine
-
a
fatty meal
-
theophylline
-
calcium shannel blockers
anticholinergic drugs as these lower the oesophageal
-
,
Sphinster pressure
>
-
diagnosis can be made on the basis of typical symptoms
as
long as alarm features for malignancy are not present :
dysphagia
-
-
unintentional weight loss
-
melgena
-
haematemesis
Waterbrash
-
: excessive secretion of saliva into the mouth
in pts With peptic uler
>
may occur ,
uncommonly a vomiting
-
.
,
↓ isease or oesophagitis
-
timing of the vomiting
>
-
vamiting delayed Ihr after the meal is typical of gastris
outlet
gastroparasis
obstruction or
>
-
early morning vomiting before eating =
pregnancy , alcoholism
raised intracranial pressure
-
contents of the vomitus
>
-
bils : an open connection between the duodenum 3 stomach
>
-
and food =
gastric outlet obstruction
>
-
blood : ulseration
-
vamiting with little /no nausea =
bowel obstruction
, ABDOMINAL BLOATING
SWELLING
-
a feeling of swelling (bloating) may be a result of excess gas
LETHARG patigability
WI acute/chronic liver
are common
disease
symptom o a
or a
hypersensitive intestinal tract (as occurs in IBS) pts .
-
persistent swelling san be due to ascitic fluid accumulation -
mechanism is unknown
be associated wh ankle Gedema ↑ can also occur due to gastrointestinal or chronic
may
-
-
inflammatory disease
very common in the general population
-
: not a
specific symptam N
-
relatives notice a yellow discoloration of the scleode
or skin before the p5 gloss .
-
due to a presence of excess bilirubin being deposited
in the conjunctivat is skin
S
-
ask about the color of the urine 3 stools
>
-
pale stools dark urine occur w/ obstructive or
cholestatic jaundice because urobilinogen is unable
to reach the intestine
-
ask about abdominal pain -> e .
g .
gallstones can
cause biliary pain & jaundice
L
can be a problemingintotheskin,fromthenosemouth-t
liver disease
REGURGITAN
retrosternal area
burning pain / discomfort in t oe
>
-
Sensation typically travels up towards the throat 3 accurs
after meals or is
aggravated by bending stooping ,
or
lying supine T
> antacids
usually relieve the pain
-
> due
-
to regurgitation of stomach contents into the oesophagus
-
usually acidic although occasionally alkaline reflux can
,
induce similar problems
-
acid regurgitation : associated with gastro-oesophageal
reflux in which experiences sour/bitter
, the pt . a
tasting fluid caming up into the mouth
>
strongly suggests that reflux is occuring
-
>
-
some pts Complain of a cough that troubles
. them when L
they lie down
>
-
the lower oesophageal sphincter muscle relaxes
in appropriately
>
symptoms may be aggravated by :
-
-
alcohol
-
chocolate
-
Caffeine
-
a
fatty meal
-
theophylline
-
calcium shannel blockers
anticholinergic drugs as these lower the oesophageal
-
,
Sphinster pressure
>
-
diagnosis can be made on the basis of typical symptoms
as
long as alarm features for malignancy are not present :
dysphagia
-
-
unintentional weight loss
-
melgena
-
haematemesis
Waterbrash
-
: excessive secretion of saliva into the mouth
in pts With peptic uler
>
may occur ,
uncommonly a vomiting
-
.
,
↓ isease or oesophagitis
-
timing of the vomiting
>
-
vamiting delayed Ihr after the meal is typical of gastris
outlet
gastroparasis
obstruction or
>
-
early morning vomiting before eating =
pregnancy , alcoholism
raised intracranial pressure
-
contents of the vomitus
>
-
bils : an open connection between the duodenum 3 stomach
>
-
and food =
gastric outlet obstruction
>
-
blood : ulseration
-
vamiting with little /no nausea =
bowel obstruction
, ABDOMINAL BLOATING
SWELLING
-
a feeling of swelling (bloating) may be a result of excess gas
LETHARG patigability
WI acute/chronic liver
are common
disease
symptom o a
or a
hypersensitive intestinal tract (as occurs in IBS) pts .
-
persistent swelling san be due to ascitic fluid accumulation -
mechanism is unknown
be associated wh ankle Gedema ↑ can also occur due to gastrointestinal or chronic
may
-
-
inflammatory disease
very common in the general population
-
: not a
specific symptam N
-
relatives notice a yellow discoloration of the scleode
or skin before the p5 gloss .
-
due to a presence of excess bilirubin being deposited
in the conjunctivat is skin
S
-
ask about the color of the urine 3 stools
>
-
pale stools dark urine occur w/ obstructive or
cholestatic jaundice because urobilinogen is unable
to reach the intestine
-
ask about abdominal pain -> e .
g .
gallstones can
cause biliary pain & jaundice
L
can be a problemingintotheskin,fromthenosemouth-t
liver disease
