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

Is dyspepsia the same as GORD?

Answer 4

Nope

Dyspepsia is a range of symptoms with multiple causes; GORD is due to reflux of acid from the stomach

Question 5

Outline the Rome III criteria for functional dyspepsia

Answer 5

Feeling of fullness or epigastric pain/burning
AND no evidence of structural disease
For past 3 months, with symptom onset 6 months before diagnosis

Question 6

What is the commonest organic cause of dyspepsia?

Answer 6

Peptic ulcer disease

Question 7

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

Answer 7

At night after eating

Duodenal ulcers aggravated by stomach emptying

Question 8

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

Answer 8

H. pylori

Drugs (NSAIDs)

Question 9

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

Answer 9

Duodenum

Then stomach; don’t really occur in oesophagus

Question 10

What tests are done to diagnose H. pylori infection?

Answer 10

Stool antigen test
Urease breath test
Serology (IgA antibodies)

Question 11

Which drugs are used to treat peptic ulcer disease?

Answer 11

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

Question 12

Outline triple therapy for H. pylori eradication

Answer 12

Omeprazole + amoxicillin + clarithromycin

Omeprazole + metronidazole + clarithromycin

Question 13

Common side effects of H Pylori eradication drugs

Answer 13

Nausea and diarrhoea