Dyspepsia

Question 1

Outline the symptoms of dyspepsia

Answer 1

1. Epigastric pain that persists for more than 1 month
2. Nausea and Vomiting

Question 2

Define dyspepsia (indigestion)

Answer 2

A general term used to describe upper abdominal symptoms

Question 3

Outline the 2 types of peptic ulcer disease

Answer 3

1. Gastric Ulcer
2. Duodenal Ulcer

Question 4

Outline the differences between Gastric Ulcer and Duodenal Ulcer Disease

Answer 4

Gastric - stomach lining breaks down due to acid
- Located in the stomach
- Pain occurs when stomach is empty
- Weight loss and GI bleeding
Duodenal:
- Located in the duodenal
- Pain occurs 2-3 hours after eating
- Night awaking’s due to pain

Question 5

Describe the aetiology of symptoms

Answer 5

• Overeating, pregnancy and medicines can impair the function of the lower oesophageal sphincter –> food and acid can travel back up to the food pipe
• Pylori Infection: Increased Acid Production

Question 6

List 5 alarm symptoms for referral

Answer 6

1. Persistent vomiting
2. Reffered pain
3. Anorexia
   4 . Anaemia
4. Dark sticky stools

Question 7

List 6 common meds that cause dyspepsia

Answer 7

1. **Beta 2 agonists
2. Iron (ferrous sulphate)
3. Anticholinergics (e.g. atropine)
4. Doxycyline
5. Ascorbic Acid

Question 8

Define GORD

Answer 8

Secreted stomach acid rises up to the oesophagus (i.e the food pipe) causing heartburn

Question 9

What’s one symptom that is common between GORD, dyspepsia and PUD

Answer 9

Heartburn

Question 10

List 3 Acid Suppression Therapies

Answer 10

1. Combination Antacids
2. H2 antagonists
3. Proton Pump Inhibitors

Question 11

How do Antacids work and provide examples?

Answer 11

Neutralises HCL secreted by parietal cells
Mylanta and Gaviscon - quick relief from indigestion and heartburn

Question 12

How do H2 Antagonists work and provide examples?

Answer 12

Competitively blocks H2 receptors on parietal cells, reducing gastric acid secretion
- Famatodine

Question 13

How do Proton-Pump Inhibitors work and provide examples?

Answer 13

Irreversibly blocks the proton pump in gastric parietal cells - reduces stomach acid production
- Pantoprazole, omeprazole

Question 14

Outline 4 practise points when taking PPI’s (prescription and OTC only)

Answer 14

• Best taken 30 to 60 minutes before a meal
• Assess ongoing use after 4 to 8 weeks for uncomplicated cases
• Step down to lowest effective dose in uncomplicated cases.
• All PPI’s except rabeprazole come as oral disintegrating tablets: mix with water, juice or yoghurt and consume within 30 minutes