B1 The pharmacology of dyspepsia Flashcards
What are the symptoms or what makes GORD worse?
1) patient complains of indigestion
2) burning feeling after eating
3) worsened by bending forwards
4) May be reflux of gastric contents into mouth
What is GORD?
It’s gastro-oesophagus reflux disease, reflux of acidic stomach contents into the oesphagus
What are the causes of GORD?
1) weak sphincter
2) relaxation of sphincter by drugs
3) increase in intra-abdominal pressure
- pregnancy
- obesity
What is gastritis?
Inflammation/ irritation of stomach lining
What makes gastritis worse?
1) alcohol
2) NSAIDs
3) infection
What is peptic ulceration?
Lining of stomach or duodenal breaks down and acid attacks tissue. Infection may lead to chronic inflammation and gastric damage (gastritis) leading to ulceration
What is Zollinger-Ellison syndrome?
Tumour secreting gastrin which stimulates gastric acid release
What is a symptom?
A clinical change in a person suggestive of disease
What is a sign?
A clinical change in a person, which may be observed by a clinician and indicate a disease
Give some common symptoms
1) cough
2) tiredness
3) aches
4) chest pains
5) breathlessness
6) indigestion
give some common signs
1) changes in skin colour
2) digital clubbing
3) heart murmurs
4) sounds on listening to lungs
5) changes to retina
What can cause chest pains?
1) usually musculoskeletal
2) respiratory
3) gastric origin (indigestion, reflux oesophagitis
4) Angina
6) heart attack
What are the signs of gastric origins?
1) relationship to food
2) relieved by antacids
What are the signs/ symptoms of angina?
1) induced by exercise, emotion stress
2) pains down arm? pains radiating to jaw?
3) relieved by rest or GTN diagnosed in history/ ECG changes
What are the signs/ symptoms of heart attack?
1) severe chest pains, not relieved by rest/GTN
2) Nausea
3) breathless
4) pains down arm/ jaw
5) diagnosed by ECG changes/ cardiac enzymes
What can cause indigestion?
1) acid stomach/ dyspepsia
2) overeating
3) reflux oesophagitis
4) peptic ulcer
5) stomach cancer
6) cardiac origin
What are the signs and symptoms of peptic ulceration?
1) epigastric pain (located by patient pointing)
2) hunger pain, relieved by eating
3) night pain, relieved by food, milk, antacids
4) waterbrash - appearance of water in mouth
5) nausea and less frequently vomiting
6) vomiting blood
What questions may you ask when diagnosing dyspepsia?
1) symptoms
2) precipitating factors
3) relieving factors
4) medicines tried
5) medication on
What can the warning signs be?
1) Aged over 55 years
2) weight loss
3) anaemia
4) dysphagia (difficulty in swallowing)
5) haematemesis (vomiting blood)
6) melaena ( tarry stools)
7) upper abdominal masses
8) persistent symptoms with repeat OTC remedies, onset of new symptoms
What are the goals of treatment?
1) symptomatic relief or cure
2) suppression of acid release or activity and mucosal protection
3) cure may involve suppression of acid release to allow natural healing and if appropriate, eradication H.pylori infection
What lifestyle changes might symptomatic relief cause?
1) avoidance of causative drugs
2) avoidance of causative food
3) smoking cessation
4) GORD - propping up bed, removing belts
