Dyspepsia and Peptic Ulcer Disease Flashcards
What are the 2 groups of causes of dyspepsia? Which is most common?
Organic causes Functional dyspepsia (most common)
Give examples of organic causes of dyspepsia
Peptic ulcer disease
Drugs (NSAIDs)
Gastric cancer
What is meant by functional dyspepsia?
Dyspepsia symptoms with no evidence of structural disease, i.e. not due to ulcers or H. pylori
Usually assoc. with functional gut disorders
Is dyspepsia the same as GORD?
Nope
Dyspepsia is a range of symptoms with multiple causes; GORD is due to reflux of acid from the stomach
Outline the Rome III criteria for functional dyspepsia
Feeling of fullness or epigastric pain/burning
AND no evidence of structural disease
For past 3 months, with symptom onset 6 months before diagnosis
What is the commonest organic cause of dyspepsia?
Peptic ulcer disease
When does pain related to peptic ulcer disease often come on? How is it described?
Pain which radiates to the back
At night after eating
Duodenal ulcers aggravated by stomach emptying
What are the two most common causes of peptic ulcer disease?
H. pylori
Drugs (NSAIDs)
Where are peptic ulcers more common - the oesophagus, stomach or duodenum?
Duodenum
Then stomach; don’t really occur in oesophagus
What tests are done to diagnose H. pylori infection?
Stool antigen test
Urease breath test
Serology (IgA antibodies)
Faecal antigen test
Which drugs are used to treat peptic ulcer disease?
Antacids (Gaviscon)
H2 antagonists (ranitidine)
PPI (omeprazole)
Outline triple therapy for H. pylori eradication
Omeprazole + amoxicillin + clarithromycin
Omeprazole + metronidazole + clarithromycin
If a patient is still symptomatic after H. pylori triple therapy, a retest to detect the organism is done. How long must a PPI be stopped before retest is done?
2 weeks
What are the signs of dyspepsia?
Epigastric pain/ burning
Postprandial fullness
Early satiety
What must be rule out when treating peptic ulcer disease?
Gastric cancer
