Discover and read the best of Twitter Threads about #GastroTwearls
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A 4๏ธโฃ tweet guide on investigating and managing:
๐ฉธ๐๐ฟ๐ผ๐ป ๐ฑ๐ฒ๐ณ๐ถ๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ ๐ฎ๐ป๐ฎ๐ฒ๐บ๐ถ๐ฎ (IDA)
for GPs & non-Gastroenterology colleagues.
Defined as:
โฌ๏ธ๐ฉธHaemoglobin levels
(based on your local laboratory reference range)
cฬ โฌ๏ธ MCV / MCH
#GastroTwearls 1/
๐ฉธ๐๐ฟ๐ผ๐ป ๐ฑ๐ฒ๐ณ๐ถ๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ ๐ฎ๐ป๐ฎ๐ฒ๐บ๐ถ๐ฎ (IDA)
for GPs & non-Gastroenterology colleagues.
Defined as:
โฌ๏ธ๐ฉธHaemoglobin levels
(based on your local laboratory reference range)
cฬ โฌ๏ธ MCV / MCH
#GastroTwearls 1/
Check:
๐Haematinics
โ๏ธCoeliac Ab (3-5% of IDA)
๐treat โฌ๏ธ B12/ folate
โ no need for FIT
โ Confirm IDA
โฌ๏ธ ferritin or
โฌ๏ธ transferrin sats or
โฌ๏ธ TIBC ๐ข๐ฏ๐ฅ โฌ๏ธ iron or
โฌ๏ธ CHr or
โฅ 10 g/L โฌ๏ธ Hb cฬ 2/52 iron
โ โฌ๏ธ iron ๐ข๐ญ๐ฐ๐ฏ๐ฆ (?anaemia of chronic disease)
#GastroTwearls 2/
๐Haematinics
โ๏ธCoeliac Ab (3-5% of IDA)
๐treat โฌ๏ธ B12/ folate
โ no need for FIT
โ Confirm IDA
โฌ๏ธ ferritin or
โฌ๏ธ transferrin sats or
โฌ๏ธ TIBC ๐ข๐ฏ๐ฅ โฌ๏ธ iron or
โฌ๏ธ CHr or
โฅ 10 g/L โฌ๏ธ Hb cฬ 2/52 iron
โ โฌ๏ธ iron ๐ข๐ญ๐ฐ๐ฏ๐ฆ (?anaemia of chronic disease)
#GastroTwearls 2/
โ๏ธ Confirmed IDA
โStart ๐ข๐ก๐ iron tablet daily
๐ฉธAsk if bleeding from:
๐๐ฝNose, refer ๐ ENT
๐ฃHaemoptysis ๐ Resp
๐งHaematuria (+ve dip) ๐ Urology
๐ฉฒHeavy PV bleeding (ask if clots/ flooding) in menstruating ๐ฉ๐ป
or
๐ฉฒPV bleeding in menopausal ๐ฉ๐ผโ๐ฆฐ
๐ Gynae
#GastroTwearls 3/
โStart ๐ข๐ก๐ iron tablet daily
๐ฉธAsk if bleeding from:
๐๐ฝNose, refer ๐ ENT
๐ฃHaemoptysis ๐ Resp
๐งHaematuria (+ve dip) ๐ Urology
๐ฉฒHeavy PV bleeding (ask if clots/ flooding) in menstruating ๐ฉ๐ป
or
๐ฉฒPV bleeding in menopausal ๐ฉ๐ผโ๐ฆฐ
๐ Gynae
#GastroTwearls 3/
I have vetted ~3๏ธโฃ0๏ธโฃ0๏ธโฃ 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 7๏ธโฃ tweets
#GastroTwearls 1/7
Pathways vary around the country - nevertheless I have observations / advice about managing common GI problems in primary care & when to refer in 7๏ธโฃ tweets
#GastroTwearls 1/7
Simple GORD does not need an OGD. This is as per national guidance as OGDs arenโt pleasant & rarely changes management.
See #GastroTwearl๐๐ผ
When giving a PPI, Omeprazole is better than Lansoprazole (fewer SEs) - give a decent dose of 40 mg / day
2/7
See #GastroTwearl๐๐ผ
When giving a PPI, Omeprazole is better than Lansoprazole (fewer SEs) - give a decent dose of 40 mg / day
2/7
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 4๏ธโฃ tweet guide.
3/7
Opioids are a major culprit and cause much misery - give concomitant laxatives.
See #GastroTwearl below for a 4๏ธโฃ tweet guide.
3/7
A 4๏ธโฃ tweet guide on investigating and managing:
๐ฉธ๐๐ฟ๐ผ๐ป ๐ฑ๐ฒ๐ณ๐ถ๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ ๐ฎ๐ป๐ฎ๐ฒ๐บ๐ถ๐ฎ (IDA)
for GPs and non-Gastroenterology colleagues.
Defined as:
๐ฉธHaemoglobin levels
๐๐ปโโ๏ธ< 110 g/L
๐๐ผโโ๏ธ< 100 g/L
with โฌ๏ธ MCV / MCH
#GastroTwearls 1/
๐ฉธ๐๐ฟ๐ผ๐ป ๐ฑ๐ฒ๐ณ๐ถ๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ ๐ฎ๐ป๐ฎ๐ฒ๐บ๐ถ๐ฎ (IDA)
for GPs and non-Gastroenterology colleagues.
Defined as:
๐ฉธHaemoglobin levels
๐๐ปโโ๏ธ< 110 g/L
๐๐ผโโ๏ธ< 100 g/L
with โฌ๏ธ MCV / MCH
#GastroTwearls 1/
New anaemia case:
๐Check haematinics
โ๏ธDonโt forget coeliac screen
Confirm IDA:
โ โฌ๏ธ ferritin or
โ โฌ๏ธ transferrin sats or
โ โฌ๏ธ TIBC & โฌ๏ธ iron ๐ต๐ฐ๐จ๐ฆ๐ต๐ฉ๐ฆ๐ณ
โ ๐ฏ๐ฐ๐ต โฌ๏ธ serum iron alone (can be anaemia of chronic disease)
๐Correct โฌ๏ธ B12 / folate
#GastroTwearls 2/
๐Check haematinics
โ๏ธDonโt forget coeliac screen
Confirm IDA:
โ โฌ๏ธ ferritin or
โ โฌ๏ธ transferrin sats or
โ โฌ๏ธ TIBC & โฌ๏ธ iron ๐ต๐ฐ๐จ๐ฆ๐ต๐ฉ๐ฆ๐ณ
โ ๐ฏ๐ฐ๐ต โฌ๏ธ serum iron alone (can be anaemia of chronic disease)
๐Correct โฌ๏ธ B12 / folate
#GastroTwearls 2/
โ๏ธ When confirmed IDA
โStart ๐ข๐ก๐ iron tablet daily
๐ฉธAsk if bleeding from:
๐๐ฝNose, refer ๐ ENT
๐ฃHaemoptysis, ๐ Resp
๐งHaematuria, ๐ Urology
๐ฉฒHeavy PV bleeding in menstruating ๐ฉ๐ป(ask about clots / flooding) or
๐ฉฒPV bleeding in menopausal ๐ฉ๐ผโ๐ฆฐ
๐ Gynae
#GastroTwearls 3/
โStart ๐ข๐ก๐ iron tablet daily
๐ฉธAsk if bleeding from:
๐๐ฝNose, refer ๐ ENT
๐ฃHaemoptysis, ๐ Resp
๐งHaematuria, ๐ Urology
๐ฉฒHeavy PV bleeding in menstruating ๐ฉ๐ป(ask about clots / flooding) or
๐ฉฒPV bleeding in menopausal ๐ฉ๐ผโ๐ฆฐ
๐ Gynae
#GastroTwearls 3/
