Gastrointestinal

1. Development of the Gastrointestinal Tract

• Be aware of the structure of the gastrointestinal tract
• Understand the foregut, midgut and hindgut (the three embryonic parts of the gut) and their boundaries
• Understand the basic anatomy of the gut, including the peritoneum (the lining of the abdominal cavity)
• Understand the mesenteries (folds of peritoneum that attach the bowel to the back wall) and omenta (folds of peritoneum that connect the stomach to nearby organs)
• Understand which organs are peritoneal (wrapped in peritoneum) and which are retroperitoneal (lying behind the peritoneum)
• Understand the embryological development of the gut and how the gut's development relates to how it works

2. Abdominal Wall and Inguinal Canal

• Build the abdominal wall layer by layer.
• Use that anatomy to predict the rings (openings) and boundaries of the inguinal canal (the passage through the lower abdominal wall in the groin).
• Use it to predict the routes of inguinal hernias (bulges of abdominal contents through a weak point in the wall).

3. Anatomy and Physiology of the Foregut

• Be aware of the boundaries of the foregut
• Understand the embryological development of the foregut
• Understand the organs associated with the foregut
• Be aware of the nerve supply and blood supply of the foregut and how they relate to pain and where it is felt

4. Anatomy and Physiology of the Midgut

• Understand the anatomy and components of the midgut
• Understand abdominal X-rays as an investigation (a type of test)
• Understand the differences between the small and large intestines

5. Anatomy and Physiology of the Hindgut

• Understand the anatomy and components of the hindgut.
• Be aware of the nerve supply and blood supply of the hindgut and the role of each part of the hindgut.

6. Gastrointestinal Motility and the Enteric Nervous System

• Understand the gut wall, enteric plexuses (the gut's own nerve networks, found in the gut wall) and slow waves (rhythmic waves of electrical activity in the gut's smooth muscle).
• Compare the mixing (churning), propulsion (pushing food along) and fasting (between-meal) patterns of motility (movement of the gut).

7. Liver, Biliary and Exocrine Pancreatic Physiology

• Connect the lobular architecture of the liver (its repeating functional units, the lobules) with blood flow and with bile flow through the biliary system (the bile ducts and gallbladder).
• Follow pancreatic secretion, bicarbonate and how zymogens (inactive enzyme precursors) are activated only where needed, so the pancreas does not digest itself.

8. Gastrointestinal Secretion, Digestion and Absorption

• Follow a mixed meal from secretion and enzymatic digestion to enterocyte (a cell lining the small intestine) transport.
• Follow fat absorption through micelles (tiny particles that carry fat digestion products, formed with bile salts) and chylomicrons (fat-carrying particles that enter the lymphatic system).
• Follow micronutrient (vitamin and mineral) uptake.

9. Upper Gastrointestinal Pathology

• Understand risk factors, symptoms and signs, pathophysiology (how the disease process works in the body) and management of conditions of the salivary glands, oesophagus and stomach.

10. Hepatic, Biliary and Pancreatic Pathology

• Understand the common causes of liver pathology. 
• Identify the causes of jaundice and whether each arises before the liver (pre-hepatic), within it (hepatic) or after it (post-hepatic).
• Understand the symptoms, pathology, investigations and treatment of common conditions of the biliary system (the bile ducts and gallbladder) and the pancreas.

11. Intestinal Pathology

• Understand pathology, presentation, investigations and treatment of coeliac disease (an immune reaction to gluten that damages the small intestine).
• Understand the same topics for irritable bowel syndrome (IBS), a common long-term condition that causes abdominal pain, bloating and changes in bowel habit.
• Understand the same topics for diverticular disease (small pouches in the colon wall that can become inflamed).
• Diagnose and differentiate between inflammatory bowel diseases (long-term conditions in which the gut becomes inflamed), namely Crohn's disease and ulcerative colitis.
• Identify the different locations of abdominal hernias (bulges of tissue through a weak point in the abdominal wall) and understand how to classify and manage the hernias.

12. Distal Gastrointestinal Tract Pathology

• Understand presentations and causes (aetiology) of anal fissures (tears in the lining of the anus), including non-surgical and surgical treatment options.
• Identify the clinical features and urgency of perianal abscesses (collections of pus beside the anus), and the fistulas (abnormal tunnels between two surfaces) that can follow.
• Distinguish internal versus external haemorrhoids (enlarged blood vessels in and around the anus, also called piles) by anatomy, symptoms and management approaches.
• Define diarrhoea (frequent loose stools) and constipation (infrequent or hard stools) subtypes, their mechanisms, and initial treatment strategies.
• Apply appropriate conservative (non-drug) and pharmacological (drug) treatments, knowing when to refer to a specialist or ask for senior help.

13. Gastrointestinal Malignancy

• Identify common GI tract cancers and their typical anatomical locations.
• Describe risk factors and pathophysiology (how the disease develops) underlying colorectal (colon and rectal) and oesophageal cancers.
• Recognise clinical signs like bleeding, anaemia, obstruction (a blocked bowel) and weight loss.
• Understand diagnostic tools including endoscopy, imaging, and tumour markers (substances made by some cancers, or by the body in response to them, that can be found in the blood or other tissues).
• Summarise staging (how far the cancer has spread), grading (how abnormal the cancer cells look) and management principles for gastrointestinal cancers.

14. Gastroenteritis and Enterocolitis

• Define gastroenteritis (inflammation of the stomach and intestines, usually due to infection) versus enterocolitis (inflammation of the small intestine and colon). Understand how they differ in the parts of the gut affected.
• Recognise common infectious causes and pathophysiology of bowel inflammation.
• Identify key clinical features: diarrhoea, abdominal pain, vomiting, fever.
• Understand diagnostic investigations: stool cultures (tests that grow bacteria from a stool sample), blood tests, imaging indications.
• Summarise management: rehydration, dietary advice, antibiotics when appropriate.
• Recognise complications like dehydration and systemic spread (infection spreading through the whole body), and know when escalation is needed (asking for senior or specialist help).

15. Gastrointestinal Emergencies

• Recognise common causes: obstruction (a blocked bowel), perforation (a hole in the bowel wall), bleeding, inflammation and infection.
• Identify key symptoms and signs: acute pain, vomiting, bleeding, distension (a swollen abdomen) and shock (failure of the circulation, with low blood pressure and a fast pulse).
• Understand initial investigations: CT, X-ray, endoscopy, blood tests.
• Outline urgent management steps: resuscitation, antibiotics, and surgical or endoscopic intervention.
• Appreciate potential complications: peritonitis (inflammation of the peritoneum), sepsis, abscess and organ failure.