3 - Paeds - Gastro - Gastritis + Mesenteric Adenitis

Question 1

What can cause gastritis, peptic ulcer and stomach cancer in later life?
General Sx seen in all 3?

Answer 1

H Pylori being left untreated in kids

indigestion, bloating, hiccups, loss of appetite

Question 2

How to differentiate between Gastritis and PUD

Answer 2

gastritis - N+V, abdo pain
PUD - gnawing/burning feeling in abdo below ribs/above navel, relief by food/milk/antacids - ALSO - Melena or haematemesis

Question 3

Other causes of gastritis?

Answer 3

pernicious anaemia, infections, bile reflux

Question 4

H Pylori - most common cause of? found on what test? and what is found in stool? Tx if suspected? Tx if confirmed?

Answer 4

PUD/Gastritis
urease breath test (13C)
Stool antigens +ve
PPIs if suspected
Amox + met/clarithromycin if confirmed

Question 5

Lifestyle changes for Gastritis and PUD mgmt

Answer 5

smaller/frequent meals
avoid spicy/acidic foods
moderate alcohol
avoid NSAIDs
reduce smoking
manage stress

Question 6

What is mesenteric adenitis? how to diagnose?

Answer 6

non-specific abdominal pain -resolves in 24-48h

diagnosis if large mesenteric nodes seen on laparotomy/laparoscopy and appendix normal

Question 7

What often comes with mesenteric adenitis? What if pain doesn’t resolve?

Answer 7

often with RespTI and cervical LNopathy

perform appendicectomy