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Case 1 IBD > Dyspepsia and GORD > Flashcards

Dyspepsia and GORD Flashcards

1
Q

What is dyspepsia?

A

indigestion
pain in upper abdomen

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2
Q

what is GORD?

A

Gastroesophageal reflux disease
exposure of unprotected epithelium to stomach acid

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3
Q

what is a peptic ulcer?

A

A perforation or hole in the lining of the small intestine, lower oesophagus or stomach

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4
Q

what is acid secretion like in gastric ulceration?

A

normal or decreased

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5
Q

where is the damage in gastric ulceration?

A

whole gastric area

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6
Q

what is acid secretion like in duodenal ulceration?

A

increased secretion

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7
Q

where is the damage in duodenal ulceration?

A

inflammation elevated in pyloric region

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8
Q

what are risk factors to dyspepsia and GORD?

A

caffeine, smoking, alcohol, stress

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9
Q

what is non-erosive GORD?

A

heartburn

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10
Q

what is erosive oesophagitis?

A

acute inflammatory response

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11
Q

what is LOS relaxation?

A

relaxation of lower oesophageal sphincter in absence of swallowing

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12
Q

what receptor does transient LOS relaxation stimulate?

A

gastric vagal mechanoreceptors

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13
Q

what drugs are contraindicated in dyspepsia and GORD?

A

NSAIDs and aspirin

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14
Q

why do NSAIDs affect the stomach?

A

COX inhibitors reducing prostaglandins which protect stomach lining

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15
Q

what is used to prevent damage due to long term NSAID use?

A

stable prostaglandin E1 (PGE1)

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16
Q

what effect does aspirin have on the stomach?

A

irreversible inhibition of stomach protection
direct toxicity

17
Q

3 strategies of treatment?

A
  • neutralisation
  • reduction of acid secretion
  • prokinetics
18
Q

what drug classes come under neutralisation?

A

Antacids, alginates and sucralfate

19
Q

what drugs reduce acid secretion?

A

PPIs and H2 receptor antagonists

20
Q

type of prokinetics drug?

A

dopamine receptor antagonists

21
Q

what are antacids and how do antacids work?

A

weak bases that neutralise acid
buffer acid to increase pH

22
Q

what do antacids NOT do?

A

don’t prevent over production of acid

23
Q

how do alginates work?

A

form protective barrier on top of gastric contents - gel impedes reflux

24
Q

what does sucralfate do?

A

protects - treatment of ulceration

25
Q

how do PPIs work?

A

bind to cysteines of H+/K+ ATPase (proton pump) - prevents H+ movement into stomach, preventing acid formation/secretion of acid

26
Q

what is the name when all gastric acid secretion is blocked?

A

achlorhydria

27
Q

how do dopamine receptor antagonists work?

A

enhance gastric motility to increase emptying

28
Q

why are dopamine receptor antagonists barely used?

A

severe side effects

29
Q
A

Case 1 IBD (5 decks)

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