Dyspepsia Flashcards
Gastric ulcer symptoms and signs
Epigastric pain worse with food, relieved with antacids
Vomiting more common ± haematemesis
Gastric ulcer risk factors
Being elderly (lesser curve) H. pylori Smoking NSAIDs Stress
Gastric ulcer management
Endoscopy and repeat after 6-8 weeks treatment to exclude malignancy
H. pylori eradication
Lansoprazole 30mg/24h for 8 weeks
Duodenal ulcer risk factors
H. pylori
NSAIDs/steroids/SSRIs
Smoking, but lower risk
Duodenal ulcer signs and symptoms
4x more common than gastric
Epigastric pain ± weight loss, may be relieved by food
Epigastric tenderness
Duodenal ulcer management
Endoscopy, H. pylori test and eradication
Measure gastrin levels off PPI if Zollinger-Ellison suspected
Lansoprazole 30mg/24h for 4 weeks
H. pylori test
Carbon-13 Urea breath test for presence and test for eradication
Stool antigen for presence
Stop PPI 2 weeks before tests
H. pylori treatment
PPI
Clarithromycin 250mg/12h oral +
Amoxicillin 1g/12h // Metronidazole if allergic
Gastritis risk factors
Alcohol
NSAIDs
Hiatus hernia/reflux
Granulomas
Functional dyspepsia (no ulcer) treatment
PPIs and psychotherapy
Low dose amitriptyline 10-20mg each night may help
GORD causes
LOS hypotension Hiatus hernia Obesity Smoking/alcohol Pregnancy Drugs (tricyclics, antiACh, nitrates)
GORD symptoms
Salivation
Heartburn
Belching
Laryngitis
GORD complications
Oesophagitis
Barret’s oesophagus -> cancer
Iron deficiency
GORD tests
Endoscopy if >55 with ALARM symptoms
24h pH study can help if endoscopy normal
GORD treatment
Lifestyle: Lose weight, raise head in sleep, smoking cessation, avoid certain foods
Drugs: Antacids, lansoprazole 30mg/24h, ranitidine
Surgery: Nissen’s fundoplication in severe but rarely
