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1. SCREENING FOR
GASTROINTESTINAL
DISEASES
BY DR FAHAD QAISAR
FCPS MEDICINE

2. COMMON GI SYMPTOMS
 ABDOMINAL PAIN
 DYSPAHGIA
 ODYNOPHAGIA
 GI BLEED
 EPIGASTRIC PAIN
 SYMPTOMS AFFECTED BY FOOD
 EARLY SATIETY WITH WEIGHT LOSS
 CONSTIPPATION
 DIAARHEA
 FECAL INCONTINENCE
 ARTHARALGIA
 REFERRED SHOUDER PAIN
 PSOAS ABSCESS
 ABDOMINAL TENDERNESS

3. GI BLEED
o May be upper GI or lower GI Bleed
o May be hematemesis, malaena or hematochezia or PR Bleed
o May be accompanied by bloody diarrhea
o Bright red color represent pathology near rectum
o Upper GI Bleed can cause lower GI bleed too
Upper GI Bleed Lower GI Bleed
Esophageal Varices
CA stomach
Upper GI Bleed
CA Esophagus Colorectal CA
NSAIDS IBD
Gastritis Polyps
Bleeding Diathesis Hemorrhoids,Fissures

4. Dysphagia
 Difficulty swallowing is Dysphagia
 Painful swallowing is odynophagia
 May be due to a local or systemic cause
 Causes include:
• Achlasia
• Esophagitis
• GERD
• CA Esophagus
• Stroke
• Fungal infection
• Viral infection
• Esophageal spasm

5. Diarrhea
(an abnormal increase in stool quantity or volume)
 Diarrhea for 14 days in acute
 Upto 28 days in persistent
 Diarrhea for more than 28 days is chronic diarrhea
 May be infectious or non infectious
 May be drug induced
 NSAIDs and anti gout drugs can cause diarrhea
 Chronic infections like TB and HIV may cause
diarrhea
 Diseases like IBD not only cause diarrhea but also
extra-intestinal manifestations like arthritis
 Colorectal CA may present with diarrhea
 Drugs like seena and lactulose may cause factitious
diarrhea
 Coeliac disease, Sprue and pancreatic insufficiency
can cause malabsorptive diarrheas

6. Constipation
a condition of prolonged retention of fecal content
Neurogenic Muscular Mechanical Rectal lesions Drugs/diet
CNS Lesions Atony Bowel
obstruction
Hemorrhoids(thr
ombosed)
Recent GA
Multiple
Sclerosis
Malnutrition Neoplasm Preri-rectal
abscess
Antacids like Al
Cord tumours Metabolic
defects
Volvulus Anti-
cholinergics
IBS Hypothyroidism Diverticulitis Barium
Dementia Potassium
depletion
Pregnancy Diuretics
Chemotherapy
Spinal cord
lesions
Hyperparathyroi
dism
Short bowel Narcotics
Cortical
evacuation
Chronic back
pain
colostomy Renal failure

7. GERD
• Heartburn
• Regurgitation
• Belching
• Chest pain
• Anemia
• Wheeze
• Weight loss
• Sensation of lump in throat
• Coughing
• Asthma
• dysphagia

8. Peptic Ulcer
• Heartburn
• Aggravated or relieved by food
• Stomach pain
• Right shoulder pain
• Nausea
• Vomiting
• Weight loss
• Black stools
• GI bleed
• Night pain

9. Pancreatitis
 Epigastric pin radiating to back
 Nausea
 Vomiting
 Tachycardia
 Malaise
 Fever
 Jaundice
 Bluish discoloration of abdomen
 Constipation/diarrhea
 Flatulence
 Weight loss

10. IBD
 Rectal bleeding
 Chronic diarrhea
 Diarrhea with mucus
 Left sided or right sided mass
 Left sided or right sided abd pain
 Weight loss
 Nausea
 Anemia
 Clubbing
 Arthritis
 Jaundice
 Fatigue
 DVT
 Rash
 Night sweats
 uveitis

11. IBS
 Painful abdominal cramps
 Constipation
 Diarrhea
 Nausea
 Vomiting
 Anorexia
 Flatulence
 Foul breath
 No nocturnal symptoms
 No bleeding
 Symptoms relieved with defecation

12. Colorectal CA
 Rectal bleeding
 Abd pain
 Pelvic pain
 Back pain
 Sacral pain
 Changes in bowel habits
 Back pain radiating to legs
 Constipation
 Weight loss
 Fatigye
 Anemia
 Dyspnea
 Fever
 Vomiting
 Diarrhea with copious amount of mucus

13. When To Refer
 Pain at mcburny point (appendicitis)
 When retroperitoneal bleed suspected


14. THANK YOU