Last updated on 07 Jan 2013 at 2:35 PM (Abdo10)

Chronic bowel motility problems
A 35 year old South African man presents to his GP with alternating loose stools and constipation. He has not lost any weight but finds his symptoms distressing, because they have been present for a few months.

 

Applied Science for Medicine
Anatomy of the gastrointestinal tract
Physiology of normal digestion and absorption
Pathology of coeliac disease, Crohn's disease and ulcerative colitis
Role of iron, vitamin B12 and folate in erythropoiesis
Pharmacology of loperamide, erythromycin, lactulose, metoclopramide, psyllium husk 

Clinical and Communication Skills
Elicit a history from a patient with altered bowel habit; recognise 'red flag' symptoms
Perform and record an examination of the abdomen including rectal examination
Recognise depression and anxiety disorders
Differential diagnosis of altered bowel habit
Non-gastrointestinal manifestations of inflammatory bowel disease
Indications for endoscopy, abdominal X-ray (including plain film contrast studies), CT abdomen, ultrasound abdomen
Interpret coeliac disease serology, iron studies, vitamin B12/folate, faecal elastase
Classify irritable bowel syndrome according to the Rome criteria
Management of coeliac disease, irritable bowel syndrome and inflammatory bowel disease (including the use of biological therapy)
Complications of coeliac disease and inflammatory bowel disease
Prognosis of inflammatory bowel disease
Roles of the inflammatory bowel disease nurse specialist, dietitian and psychologist
Role of mindfulness meditation in irritable bowel syndrome

Personal and Professional Skills
Consent for initimate examination and use of chaperone
Effectively communicate advice regarding lifestyle
Empathise with patient with chronic disease
Awareness of mind-body interaction in clinical conditions

Hauora Māori
Cater for differential health literacy needs of Māori patients and whānau
Consideration of access to cultural/spiritual support for patient and whānau

Population Health
Epidemiology in New Zealand of inflammatory bowel disease, irritable bowel syndrome and coeliac disease and burden of these conditions (in New Zealand and globally)

 

Conditions to be considered relating to this scenario

Common

irritable bowel syndrome, inflammatory bowel disease, gastroenteritis, anxiety disorder, coeliac disease, dyspepsia, drug induced

Less common but 'important not to miss'

colorectal cancer

Uncommon

pancreatic insufficiency, chronic pancreatitis, chronic ischaemic gut, carcinoid syndrome, eosinophilic gastroenteritis