Dyspepsia and H. Pylori Flashcards
What symptoms are associated with dyspepsia
abdominal pain loss of appetite N&V bloating early satiety heartburn
When should you do an endoscopy for patient with dyspepsia
ALARMS anorexia loss of weight anaemia recent onset and over 55 melaena / haematemesis or mass swallowing difficulties
If patient has no alarm features and is under 55 what should you test for?
H. pylori
Treatment for H. Pylori
Eradication therapy for 7 days:
- amoxicillin
- clarithromycin
- PPI
Drug history
NSAIDS
steroids
biphosphonates
CCB’s
Lifestyle history
diet exercise alcohol smoker weight loss
Bloods investigations
FBC and ferritin U&E's LFT's Serum IgA Calcium
What type of bacteria is H. pylori
Gram -ve
How is H. Pylori described
spiral
microaerophilic
flagellated
When would someone usually acquire H. pylori
in childhood
Where can H. pylori colonise and what can it do
In the mucosa of the stomach
evoke an immune response
Complications of h. pylori infection (mild - severe)
Chronic gastritis
chronic atrophic gastritis intestinal metaplasia
gastric or duodenal ulcer
gastric cancer
how does the site of colonisation affect the outcome of a H pylori infection?
Antrum - increased acid = duodenal disease
Body - decreased acid - gastric atrophy - cancer
non-invasive diagnosis of H. pylori
Serology: IgG against H. pylori
13/14 carbon urea breath test
ELISA of stool
invasive diagnosis of H.pylori
Culture gastric biopsies for bacteria
CLO test
