Summary MRCP Gastrointestinal History Taking

GI

 General  WAFFLE
o Weight loss
o Abdominal pain or bloating
o Fever
o Foreign travel
o Loss of appetite
o Eye yellowness
 Head-to-toe:
o Mouth  Ulcers
o Oesophagus  Dysphagia (solids vs liquids)/odynophagia
o Stomach:
 N+V ± haematemesis
 Indigestion/reflux/heartburn/chest pains
o Bowels:
 Diarrhea, constipation, passing wind, blood (fresh or melena)?
 Pain on defecation

 Liver (only in depth if differential):
o Jaundice/yellow eyes or skin
o Pale stool or dark urine
o Foreign travel
o Alcohol
o Tattoos
o Sexual Hx (MSM)
o Blood transfusion
o IVDU

 Urinary  Dysuria + Haematuria
 Gynae  LMP

 ICE

 PMH  Bowel problems
 PSurgHx  Operation
 FH  Cancer, bowel problems
 DH (NSAIDs?), SHx

 Summary + Differentials


Ix: Urine dip, blood, AXR, Abdo USS, endoscopy

ALL UPPER GI = ALARMS, WAFFLE
ALL LOWER GI = General questions, WAFFLE

, Common Surgical Symptoms in Colorectal – History Taking

 Abdominal Distension:
o Symmetrical
 Fluid (ascites)
 Flatus (obstruction or ileus)
 Fetus (pregnant)
 Fat
 Flipping big mass (cancer, other)

o Asymmetrical  Localised mass
 How long?
 Does it change?
 Is it changed by vomiting or passing flatus or stool?

 Change in Bowel Habit  Change in frequency or consistency
o What do you mean? What are you normally like?
o How long?
o Diarrhea or constipation, or both?
o Blood, pain?
o Transient or persistent?

 Frequency AND Urgency of Defecation (always pathological)
o How long can you delay?
o Discomfort?
o Is the stool which is passed normal?

 PR Bleed
o What colour? (light = anal, darker = colonic, black = upper GI)
o In toilet? Mixed with stool or separate? On toilet paper?

 Tenesmus (feeling of incomplete defecating)  Rectal pathology, highly specific for colon cancer