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BGIT (LGIT (Colon (Colitis (Inflammatory (IBD) (UC (usually from caecum…
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Epidem: Usually Indians or Malay
Mucoids, bloody diarrhoea
Autoimmune disease - T1DM, thyroid diseases, vitiligo
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Ask hx to check location
Blood in stool -> fresh blood? Mixed with stools?
Anal sex?
Pencil-thin stools - usually anus area rather than rectum
Abdominal pain (~44%)
Constitutional symptoms
Haematochezia vs melena
Any symptomatic anaemia? (usually chronic microcytic anaemia rather than massive blood loss)
Any risk factors?
Malignancy Ix for GS:
- OGD (to confirm diagnosis)
- TNM staging (endoscopic US, chest, abdo pelvis CT, laproscopy)
- FBC, renal panal (for electrolyte imbalance), LFT (albumin is a nutritional marker, ALP is elevated in malignancy)
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Med/Drug hx:
- NSAIDs
- TCM (usually steroids)
Red flags for change in bowel habits:
Alternating constipation and diarrhoea
Spurious diarrhoea
Pencil-thin stools
Tenesmus (feeling of defecation + pain)
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Complications
- Symptoms of dehydration and shock
- Symptoms of anaemia