1. Upper GI Disease Flashcards
Medication used to treat upper GI disease can (3)
Eliminate formed acid/neutralise stomach acid
Reduce acid secretion
Improve mucosal barrier
Which medication eliminates formed acid/neutralises stomach acid
Antacids
Which medications reduced acid secretion (2)
Hydrogen receptor pump
Proton pump inhibitors
How do medications improve mucosal barrier (2)
Eliminate helicobacter
Inhibit prostaglandin removal
Drugs that exacerbate upper GI disease (2)
NSAIDs (stop PG production and prevent healing)
Steroids - damage ulcer healing process
Mechanism of hydrogen receptor antagonists
Reduce acid production by preventing histamine activation of acid production
Limitations of hydrogen receptor antagonists
Alternative pathways still operate (that can be inhibited by ACh and gastrin)
Types of hydrogen receptor antagonists (2)
Ranitidine
Cimetidine
Types of proton pump inhibitors (3)
Omeprazole
Lansoprazole
Pantoprazole
Examples of oral diseases (3)
ROU
Lichen planus
OFG
Examples of oesophageal disorders (3)
Dysphagia
Dysmobility disorders
GORD
Definition of dysphagia
Food sticking in throat
Mechanical block/compression, may be intermittent
Types of dysphagia (3)
Functional
Dysmobility
Due to external compression
Causes of GORD (3)
Deective lower oesophageal sphincter
Impaired lower clearing
Impaired gastric emptying
GORD may cause (3)
Ulceration
Inflammation
Metaplasia
Signs/symptoms of GORD (4)
Epigastric burning - worse when lying down, bending, during pregnancy
Dysphagia - oesophagi’s, stricture, dysmobility
GI bleeding
Severe pain (mimics MI) - oesophageal muscle spasm/suspected MI
What might Barrett’s oesophagus be caused by
Recurrent acid reflux into the lower part of the oesophagus
Tissue change of Barrett’s oesophagus (2)
Metaplasia of oesophageal lining (metaplastic change to gastric-type mucosa)
Associated with a malignant change (adenocarcinoma)
Definition of hiatus hernia
When a part of the stomach pushes above the diaphragm into the thorax
Symptoms of hiatus hernia are similar to
GORD symptoms
Hiatus hernia is more common in
Women
GORD management involves (4)
Smoking cessation (improves sphincter)
Lose weight, avoid triggering activity
Medication
Increase GI motility and gastric emptying
Medications involved with GORD management (2)
Antacids
Hydrogen blockers
Proton pump inhibitors
Where can PUD appear
On any acid affected site (oesophagus, stomach, duodenum)
Causes of PUD (3)
High acid secretion (duodenal)
Normal acid secretion but reduced protective barrier (stomach)
Drugs (NSAIDs, steroids)
Excessive acid production can lead to (2)
Oesophageal ulcers
Duodenal ulcers
Normal acid levels lead to
Reduced protective barrier
PUD due to normal acid levels usually involves
H. pylori
H. pylori infection causes (2)
Gastric ulcers
Chronic gastric wall inflammation (stomach lymphoma)
H. pylori treatment (2)
Triple therapy
Involves two antibiotics and one PPI
Antibiotics used in H. pylori treatment (2)
Amoxicillin (clarithromycin if allergic)
Metronidazole
PPI used in H. pylori treatment
Omeprazole
Signs and symptoms of PUD (3)
Often asymptomatic/none
Epigastric burning pain
Usually no physical signs
Description of PUD related epigastric pain (3)
Worse before/just after meals
Worse at night
Relieved by food, alkali, vomiting
When do PUD physical signs occur
When complications occur (bleeding, perforation, etc.)
PUD investigations (4)
Endoscopy (oesophagus, stomach, duodenum)
Radiology (barium meal/swallow)
Anaemia tests (FBC, FOB)
H. pylori tests (breath, antibodies, mucosa)
Complications of PUD can be (2)
Local
Systemic
Local complications of PUD include (4)
Perforation
Haemorrhage
Stricture
Malignancy
Systemic complications of PUD include
Anaemia
PUD treatment (9)
Smoking cessation Eat small, regular meals Eradication therapy Ulcer healing drugs Endoscope Medical intervention Surgical intervention Gastrectomy Vagotomy
When does PUD treatment involve medical intervention (2)
When reversible problems are present (lifestyle changes)
When H. pylori is present
When does PUD treatment involve surgical intervention
When complications occur