Diseases of stomach and duodenum

Question 1

What is the symptomatic treatment for acute gastritis?

Answer 1

1. Antacids
2. PPIs
3. Prokinetics (domperidone) or
4. antiemetics (metoclopramide)

Question 2

What are the non-invasive investigations for detecting H. pylori?

Answer 2

1. Fecal antigen test
2. Urea breath test
3. Serology

Question 3

What are the invasive investigations for detecting H. pylori?

Answer 3

1. Microbiology
2. Rapid urease test
3. Histology

Question 4

Outline H. pylori eradication

Answer 4

1 PPI taken simultaneously with 2 antibiotics (clarithromycin, amoxicillin, or metronidazole) for 7 days

Question 5

What are side-effects of H. pylori eradication?

Answer 5

1. Diarrhea
2. Nausea, vomiting
3. Headache
4. Rash
5. Flushing and vomiting if taken with alcohol

Question 6

What are emergency indications for surgery in peptic ulcer?

Answer 6

1. Perforation

2. Hemorrhage

Question 7

What is the operation of choice for a chronic non-healing ulcer?

Answer 7

Partial gastrostomy with Billroth 1 anastomosis

Question 8

What is the emergency surgery for a perforated or hemorrhagic ulcer?

Answer 8

1. Perforation - oversewing (patch repair)

2. Hemorrhage - under running for bleeding

Question 9

What is the surgical management of gastric cancer?

Answer 9

Total gastrectomy with lymphadenectomy

Question 10

What is the palliative care for gastric cancer?

Answer 10

Chemotherapy
Endoscopic laser ablation (particularly for dysphagic patients or recurrent bleeding) or metallic stents (dysphagia and/or vomiting)
If patient has gastric outlet obstruction - nasogastric tube