Dyspepsia and Hpylori Flashcards
1
Q
What are the two types of dyspepsia?
A
- Functional – dyspepsia but no underlying cause, normal endoscopy
- Uninvestigated – symptoms in patients who’ve not had an endoscopy
2
Q
What are the symptoms of dyspepsia?
A
- Upper abdominal pain for 4 weeks or more
- Heartburn
- Acid reflux
- Fullness
- Bloating
- Nausea & vomiting
3
Q
What are the causes of dyspepsia?
A
- GORD
- Peptic ulcer disease
- Gi malignancy
- SE of drugs
- Lifestyle
4
Q
What are the red flags for dyspepsia?
A
- Bleeding
- Dysphagia
- Recurrent vomiting
- Weight loss
- 55+ unexplained recent onset
5
Q
What required urgent endoscopic investigation?
A
- Dysphagia
- Significant acute Gi bleeding
- Over 55 years with unexplained weight loss and upper abdominal pain, reflux or dyspepsia
6
Q
What lifestyle advice can be given for dyspepsia?
A
- Weight loss
- Reducing alcohol and smoking cessation
- Improve diet (sugar, fatty foods, spicy)
- Raise cushion to avoid acid reflux
- Stop/avoid medications that cause dyspepsia
7
Q
What is the treatment for dyspepsia?
A
- Lifestyle
- Antacid / alginates
- PPI for 4 weeks (Leave a 2 week wash out period after PPI use before testing for Hpylori)
- Offer H2 receptor antagonist if inadequate response to PPI
If symptoms persist use PPI or h2 antagonist when required
8
Q
What drugs can cause dyspepsia?
A
- Alpha blockers & beta blockers
- Antimuscarinic
- Aspirin
- Alendronic acid
- Bisphosphonates
- NSAIDS
- Corticosteroids
- Nitrates
- Theophylline
- CCB
- TCA’s
- SSRI’s
9
Q
What is the test for HPYLORI?
A
UREA 13C, SAT or blood test
10
Q
When do you not perform the urea test for hpylori?
A
- Within 4 weeks of antibiotic treatments
- Within 2 weeks of PPI treatment
- Retesting should be performed 4 weeks after treatment
11
Q
What drugs are used to treat Hpylori?
A
- PPI
- Clarithromycin
- Amoxicillin/ metronidazole
- Tetracycline/levofloxacin
- Bismuth subsalicylate
- Rifabutin or furazolidone
