13: Dyspepsia and peptic ulcer disease Flashcards
What is dyspepsia?
Burning epigastric pain
Pathology in which section of the gut produces epigastric pain?
Foregut
Infection with which bacteria can cause dyspepsia?
H. pylori
Which class of drugs can cause peptic ulcers associated with dyspepsia?
NSAIDs (aspirin, ibuprofen)
What are some organic causes of dyspepsia?
Peptic ulcers
Drugs (NSAIDs)
Gastric cancer
75% of dyspepsia cases are ___.
idiopathic
no clear cause
Which functional gut disorder can cause dyspepsia?
IBS
Irritable bowel syndrome
What is a common disease causing organic dyspepsia?
Peptic ulcer disease
Where is pain associated with peptic ulcers felt?
Epigastrium
Where can pain associated with peptic ulcers radiate?
Back
What can aggravate dyspepsia caused by peptic ulcers?
Eating
Which bacteria causes peptic ulcer disease?
H. pylori
What drugs cause peptic ulcer disease?
NSAIDs
When do people tend to acquire H. pylori?
Childhood
H. pylori is a Gram (positive / negative) (cocci / bacillus).
Gram -ve bacilli
Where do peptic ulcers arise?
Stomach
Duodenum
1% of those infected with H. pylori go on to develop gastric ___.
cancer
Which hormones stimulates the release of hydrochloric acid from parietal cells?
Gastrin
Histamine
Which cells release gastrin?
G cells
When food enters the stomach, the pH ___.
increases
Increasing pH causes an (increase / decrease) in the amount of gastrin secreted by G cells.
increase
H. pylori related gastritis causes an increase in the secretion of ___ by _ cells.
What is a consequence of this?
gastrin , G cells
Increased HCl secretion leading to gastric / duodenal ulcers
Ulcers which burrow into arterioles are at a high risk of ___.
bleeding
Gastric ulcers can be ___ or ___.
acute , chronic
Large, irregular looking gastric ulcers are indicative of ___.
cancer
Which enzyme is used to test for H. pylori infection?
Urease
What material can be tested for H. pylori antigens?
Faeces
Which enzyme, expressed by H. pylori, can be used to test for its presence?
Urease
What sort of test is commonly used to detect H. pylori in the stomach?
Urease BREATH test
All patients with peptic ulcer disease are given which class of drug?
PPIs (e.g omeprazole)
anti-secretory
All patients with peptic ulcer disease are tested for the presence of which bacteria?
H. pylori
Which drugs should be withdrawn if a patient has peptic ulcer disease?
NSAIDs
Which triple therapy is used to eradicate H. pylori?
PPI + 1g Amoxicillin BD + Clarithromycin 500mg BD
or
PPI + 400mg Metronidazole BD + Clarithromycin 250mg BD
H. pylori eradication therapy tends to cause ___ and ___.
nausea
diarrhoea
Why may a peptic ulcer patient develop anaemia?
Bleeding
What may happen to the wall of the stomach / duodenum if a peptic ulcer penetrates it deeply?
Perforation
Patients with untreated peptic ulcers may develop GI tract ___ due to fibrosis.
obstruction