GEP Medicine in Society Guide 2024/25

6. Themed Days - Primary Care

6.14. Nutrition and gastrointestinal disorders

Preparatory work 

In preparation you should have: 

Watch Michael serres , in this 5-minute video, talk about his experience of Crohn’s disease and having a bowel transplant. What stood out for you from his experience? You should reflect upon his experience of his interaction with healthcare practitioners and be ready to discuss this on the day.

Looked at the resources on the NHS Live Well website. Specifically focus on how to eat a balanced diet, the benefits of exercise and why we should sit less why we should sit less . For the session, you should think of 1 key point from each topic that you was new information for you to discuss.

Reviewed guidance information from The Mental Health Foundation  on wellbeing and nutrition.  You should be able to discuss 3 key points discussing how what we eat can affect are mental health.

Watch this video from the Crohn’s and Colitis UK website. For the day you should be able to discuss what might be some of the symptoms someone might experience? Can you think of what of the impact might be and why?

Watch this 2-minute video where a doctor outline what Irritable Bowel Syndrome is. For the session, you should be ready to discuss why this might be difficult for a doctor to diagnose. You should then take the next step and discuss the impact this challenge might have upon the patient.

Aims 

To increase your awareness of the relationship between food, health and ill health and to introduce students to patient presentations with GI disorders. 

Learning outcomes 

By the end of the day, you should be able to: 

Describe the components of a ‘healthy diet’

List the current recommendations for daily exercise

Describe some of the broad spectrum of symptoms that relate to the GI tract

Discuss and explain the impact of a chronic bowel disorder on a patient’s life

Discuss how embarrassing symptoms might influence people’s decision to visit their doctor

Discuss the role of the primary care team in encouraging people to lead healthier lives

Example timetable 

9.30 – 10.30	Tutorial on GI disorders. Reflect upon the key learning points who you took away from the videos in the preparatory work. Discuss the key points in maintaining a balanced diet, regular physical activity and sitting less.
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient encounters  Plan questions and observations     Patient encounters  Interview a patient with a chronic GI condition or symptoms  Observe a new patient check and consider how lifestyle assessment and advice is broached  Role play scenarios
11.45 – 12.45	Students feedback to group on their patient encounters and group discussion    Set up afternoon activity;  In small groups visit or research local services/facilities supporting healthy lifestyle choices and/or meet someone involved with delivering these services.
12.45 – 13.45	Lunch
13.45 – 15.00	Small group research/visits/interviews as planned    1:1 formative feedback meeting with GP tutor (for 4-6 students)    Includes tea break
15.00 – 16.00	Feedback to group about visit/research/interview; link this information into the community are profile started on day 1 of the placement.    Set homework for next session

Suggested Activities 

Tutorial on GI disorders – could include students presenting about different GI disorders, discussing common GI symptoms presenting in primary care, considering the role of the primary healthcare team in assessing and advising on diet and exercise.

Introduction to abdominal examination and link this with GI symptoms.

Interview a patient with a chronic GI condition.

Role-play scenarios with a focus on how the doctor can help put a patient at ease and facilitate the discussion of potentially embarrassing symptoms and/or how to empathetically open discussions about diet and exercise with an overweight patient.

Visit or conduct online research into a local organisation relevant to diet and/or exercise e.g. local group providing advice on diet, nutrition and/or cooking to young mothers. Interview a local provider of these services e.g. meeting with fitness instructor providing ‘exercise on prescription’ or an adviser from local ‘Weight Watchers’ group.

Look at this open access collection of articles from the BMJ on nutrition and health, entitled “Food for thought” and choose an article to read and discuss as a group or in breakout groups.

Have an individual formative feedback discussion with GP tutor on progress on the course so far, including first written assessment, plan for poster assignment and professional attitude and conduct.

Questions for you to consider 

If you met a patient with a bowel disorder – how comfortable did they feel about discussing the problem?  How comfortable did you feel?  What helped or hindered your discussion?  What can you do to help put patients at ease in talking about potentially embarrassing topics?

What did you learn about weight management and nutritional advice in primary care?  Did the healthcare team see this as an important part of their role?   Do you think this should be the responsibility of the healthcare team?  What alternative sources of help/support might patients use?

You may have a meeting today with your tutor.  How do you feel you are progressing? Have you set yourself any learning outcomes as a result of your experiences so far? Were you surprised at your tutor’s analysis of your progress?