Dyspepsia and H pylori Flashcards
What is dyspepsia?
An umbrella term for a collection of symptoms:
- epigastric pain / burning
- post prandial fullness
- early satiety
+/- belching, bloating, nausea, heartburn.
DDx of dyspepsia?
Functional dyspepsia (non-organic)
Oesophagitis, GORD, gastritis, peptic ulcer,gastric cancer, biliary disease.
What is H - pylori?
Gram negative bacillus,
Infection with h pylori is picked up in early life but does not manifest until later on, the outcome are:
Nothing
Chronic gastritis
PUD
Gastric cancer (rare)
What is Virchow’s node?
An enlarged left supraclavicular lymph node that would make you suspect gastric cancer.
Eradication therapy for h pylori?
Amox + met + PPI.
If pencilllin allergic:
Clarithromycin, Metronidalzole and PPI.
Diagnostic test for H Pylroa?
Primary care = stool antigen
Secondary care= 13C urea breath test
What must a patient do before stool antigen testing for h.puyloeia?
Stop PPI for 2 weeks
Stop ABx for 4 weeks,
Duodenal ulcers are relieved by eating.
Gastric ulcers are made worse by eating.
Presentation of peptic ulcer disease?
Dyspepsia, epigastric pain.
Management = h pylor eradication.
If Dx not confirmed give a PPI trial for 4 weeks then reasses.
What is zollinger Ellison syndrome?
A neuroendocrine tumour in either the pancreas or duodenum.
Can develop on its own or part of MEN 1.
What does the tumour in zollinger Ellison syndrome secrete?
Secretes gastric which increases gastric acid production, therefore it presents with dyspepsia that is non-responsive to treatment.
treatment of zollinger Ellison syndrome?
High dose PPI, rarely gastrectomy.
What is gastroparseis?
Delayed gastric emptying
Investigation of gastroparesis?
Gastric scintigraphy.
