Dyspepsia + Peptic Ulcer Disease

Question 1

What are the 2 groups of causes of dyspepsia? Which is most common?

Answer 1

Organic causes
Functional dyspepsia (most common)

Question 2

Give examples of organic causes of dyspepsia

Answer 2

Peptic ulcer disease
Drugs (NSAIDs)
Gastric cancer

Question 3

What is meant by functional dyspepsia?

Answer 3

Dyspepsia symptoms with no evidence of structural disease, i.e. not due to ulcers or H. pylori
Usually assoc. with functional gut disorders

Question 4

What is the commonest organic cause of dyspepsia?

Answer 4

Peptic ulcer disease

Question 5

When does pain related to peptic ulcer disease often come on?

Answer 5

At night after eating
Duodenal ulcers aggravated by stomach emptying

Question 6

What are the two most common causes of peptic ulcer disease?

Answer 6

H. pylori
Drugs (NSAIDs)

Question 7

Where are peptic ulcers more common - the oesophagus, stomach or duodenum?

Answer 7

Duodenum
Then stomach; don’t really occur in oesophagus

Question 8

What tests are done to diagnose H. pylori infection?

Answer 8

Stool antigen test
Urease breath test
Serology (IgA antibodies)

Question 9

Which drugs are used to treat peptic ulcer disease?

Answer 9

Antacids (Gaviscon)
H2 antagonists (ranitidine)
PPI (omeprazole)

Question 10

Outline triple therapy for H. pylori eradication

Answer 10

Omeprazole + amoxicillin + clarithromycin
Omeprazole + metronidazole + clarithromycin

Question 11

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?

Answer 11

2 weeks