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
how do PPIs work?
bind to cysteines of H+/K+ ATPase (proton pump) - prevents H+ movement into stomach, preventing acid formation/secretion of acid
26
what is the name when all gastric acid secretion is blocked?
achlorhydria
27
how do dopamine receptor antagonists work?
enhance gastric motility to increase emptying
28
why are dopamine receptor antagonists barely used?
severe side effects
29