Dyspepsia Flashcards
What is dyspepsia and how may it present?
chronic symptoms attributed to the gastroduodenal region:
- pain/discomfort
- belching
- nausea/vomiting
- rumination
Causes of acute epigastric pain
acute pancreatitis
perforated peptic ulcer
peptic ulcer
acute cholecystitis
biliary colic
acute cholangitis
mesenteric vascular disease
perihepatitis
supradiaphragmatic pathology
Causes of dyspepsia
functional
GORD
peptic ulcer
oesophageal cancer
gastric cancer
Gastric cancer risk factors
H pylori
age
smoking
atrophic gastritis
Peptic ulcer risk factors
H pylori
NSAIDs/aspirin
smoking
Gastroesophageal reflux risk factors
BMI
smoking
Oesophageal cancer risk factors
smoking
BMI
Barrett’s oesophagus
age
When is upper GI endoscopy useful?
diagnose cancer
diagnose ulcers
(used in dyspepsia based on cancer risk)
Upper GI cancer symptoms
dysphagia
weight loss
epigastric pain
dyspepsia
reflux
nausea
vomiting
abdominal pain
chest pain
constipation
When should a 2 week wait referral for upper GI endoscopy be used?
patients with:
- dysphagia or
- >55 + weight loss +:
- upper abdo pain/reflux/dyspepsia
Non-invasive H pylori tests
faecal antigen
urea breath test
serology
Invasive H pylori tests
biopsy:
- urease
- histology
- culture
- PCR
GORD management
lifestyle measures
lowest dose to control symptoms:
- PPI/H2RA/antacid
- except Barrett’s, severe erosive disease
surgical:
- laparoscopic fundoplication
- magnetic sphincter augmentation
Functional dyspepsia new name
post-prandial distress syndrome
