Dyspepsia + PU Flashcards
dyspepsia
indigestion
dysphagia
difficulty swallowing
ulcer
break in the continuity of an epithelial surface
25% of dyspepsias have underlying cause, what could they be?
PUD
GORD
gastritis
NSAID induced
RF duodenal ulcer
H. pylori
NSAIDs
steroids
increased acid secretion + emptying
RF gastric ulcer
H. pylori smoking NSAIDs reflux delayed emptying
war
attack vs defence
attack: acid, pepsin, H.pylori, drugs
defence: mucin, cell mucus, HCO3- secretion, cell turnover
where is mucin?
theres a protective layer of it on gastric cells
mucosal ischaemia
mucin not produced as cells are impaired from reduced blood flow
increased acid
too much overwhelms mucin
stress can induce this, as can H. pylori
symptoms
reflux heartburn bloating indigestion acid taste tender epigastrium
course of symptoms specific to DU
epigastric pain typically before meals or at night
relieved by eating or drinking milk
course of symptoms specific to GU
asymptomatic or epigastric pain
may be with/wo weightloss
Dx tests for DU
upper GI endoscopy (stop PPI 2 weeks before)
test for H. pylori (urea breath test)
Dx tests for GU
upper endoscopy to exclude malignancy
multiple biopsies from ulcer rim + base
