I have vetted ~3️⃣0️⃣0️⃣ 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 7️⃣ 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 7️⃣ 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
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 4️⃣ tweet guide.
3/7
Opioids are a major culprit and cause much misery - give concomitant laxatives.
See #GastroTwearl below for a 4️⃣ 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
💊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
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
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 1️⃣💊𝗽𝗲𝗿 𝗱𝗮𝘆!
6/7
See #GastroTwearl below 👇🏼
Also remember that when given iron tablets - 𝗻𝗼 𝗺𝗼𝗿𝗲 𝘁𝗵𝗮𝗻 1️⃣💊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
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
Thank you for reading!
Please share.
Please ask questions & discuss.
Let me know your views
For more #GastroTwearls click the link 👇🏼
Check out 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 myEndoscopy.co.uk for patient info on endoscopy procedures
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