Dyspepsia and GORD Flashcards
Dyspepsia Outline
Colloquial: indigestion. Collection of symptoms in upper GIT: upper abdominal pain, heartburn, fulness despite not eating, abdominal heaviness, nausea. Lasts up to 4 weeks
Dyspepsia Outline
Ulcer, malignant cells, H. pylori, interruptions in gut-brain interactions (neurotransmitters) and life style (eg stress) and dietary (eg exclusion diets) triggers
GORD Outline
Refluxing of stomach’s contents into esophagus. A lot of the time (not all) heartburn is present (burning sensation in retrostinum)
Causes of GORD
Anticholinergic drugs (dries out site of action), intrabdominal pressure (eg preganancy), hiatus hernia and fatty foods (lubricates mucosa less resistance to movement of food back up)
Hiatus Hernia Outline
Protrusion of stomach through muscular diaphragm. 2 types: sliding (into oesophagus) and paraoesophageal (beside oesophagus)
Signs of GORD
Pain after: food, exertion. Pain may be severe and mimic cardiac conditions. Has an association with asthma and sleep disturbances
GORD Diagnosis
Clinical diagnosis (though negative showing doesn’t rule out). Likely if: heartburn occures 2 days to a week, symtoms are relieved by antacids or PPIs
Impacts of chronic GORD
Osophageal damage. Swallowing pain, ulceration, haemorrhage, oesophageal stricture, perforation and malignancy
GORD Management
Prevent reflux. Reduce acidity of stomachs contents through medications (H2, PPI) (be careful as medication might mask more severe conditions). Lifestyle modification: tilt bed (contents flow away from mouth), have alcohol/coffee in moderation, avoid fatty foods and large meals
GORD Medication
Antacids, Alginates, H2 antagonists and proton pump inhibitors (PPIs, most severe)
Antacids Outline
Stomach acid is neutralised. Relieves symptoms in short term. Suspensions more effective then tablets. side effects of mg = diahorrea, ca = constipations and Na = cardiac diseases
Drug interactions with antacids
Binds bisphosphonates stopping bones absorbing minerals. Alters gastric pH decreasing absorption of acidic drugs
Alginate Outline
Alginate (froom algae), sodium bicarbonate and gastric acid to form a viscous gel (foam). Alkaline raft neutralises stomach contents before it reaches oesophagus. Suitable for most patients
H2 Antagonists
Prevents gastrin and Ach from binding to heterochromaffin - like cells. Reduces amount of HCl produced
PPIs Outline
Block H+-K+ ATPase pumps inhibiting gastric acid secretion. Short term treatment of reflux symptoms. 2-3 days for treatment to take full effect
Drugs Associated with Dyspesia
NSAIDs, corticosteroids and anticoagulents
