Dyspepsia + Peptic Ulcer Disease Flashcards
What is dyspepsia?
Epigastric pain or burning (epigastric pain syndrome) and postprandial fullness/early satiety often associated with nausea, belching and eating
What are causes of dyspepsia?
GORD
Peptic ulcer or non-ulcer disease
Idiopathic
What would you find on examination for someone with dyspepsia?
Epigastric tenderness on palpation
What can you check for during examination of a dyspepsia patient?
Cachexia
Mass
Evidence of gastric outflow obstruction (distension/slughing around when patient moving on auscultation)
How do you manage a patient with dyspepsia?
Lifestyle advice
Antacids
PPis
What is a peptic ulcer?
Breach of GI tract as a result of acid and pepsin attack
What are risk factors for peptic ulcer disease?
NSAIDs (short, high dose course) H. pylori Steroids Smoking Alcohol Stress
What is the microscopic appearance of a peptic ulcer?
Layered appearance, flow of fibrinopurulent debris
Base of inflamed granulation tissue
Deeper layer is fibrotic scar tissue
What is the pathophysiological a duodenal ulcer?
H. pylori - increased gastrin - increased acid - no atrophy - duodenal ulcer +/- gastric metaplasia +/- H. pylori colonisation in duodenum
H. pylori can only occupy?
Columnar epithelium
What are characteristics of H. Pylori?
Gram -ve curvilinear rod, excites early acute inflammatory response (IL-8 is critical)
If H. pylori is not cleared ______ follows causing damage to the walls and ultimately leading to _____
active inflammation
ulcers
What are investigations for peptic ulcer disease?
FBC
Carbon-13 urea test for H. pylori / Urea Breath test
Endoscopy if over 55
?malignancy
How does the breath test for H. pylori work?
Patients swallow urea which is cleaved by the H. pylori and exhale isotope labelled Carbon-13
How do you manage peptic ulcer disease?
Lifestyle advice
H. pylori radiation
Stop NSAIDs, PPIs
