Epigastric Pain Flashcards
Diagnosis for GERD
Endoscopy
Treatment for GERD
Start with lifestyle
-weight loss
-avoid triggers
-Avoid food within 3 hours of bedtime
-elevate head of bed 6-8 inches
PPI
Liquid antacids
H2 Blockers
Surgical or anatomic correction of LES
Diagnose Gastritis
Endoscopy
Test for H. Pylori
Treatment for Gastritis
PPI
Most accurate test to tell DU vs GU in PUD
Endoscopy
Most accurate test to detect H. Pylori
Biopsy
Treatment for PUD
PPI
Treatment for H. Pylori
PPI + 2 Abx
Clarithromycin and Amoxicillin
-if no response Metronidazole/Tetracycline
Can add Bismuth to change in Abx
Treatment of Functional Dyspepsia in patient < 60
Empiric PPI
-if no resolution then scope
Treatment of Functional Dyspepsia in patient > 60
Endoscopy to exclude cancer
Diagnose Gastinoma (zollinger-ellison Syndrome)
Endoscopy to confirm ulcer
-High Gastric off PPI
-High gastrin despite high gastric acid output
-Persistant high gastrin despite injecting secretin
Image
-Abd CT/MRI first
-Somatostatin-RScintography
Most accurate test for Gastinoma (zollinger-Ellison)
Functional test
-looking at response to Secretin
Treatment for Gastrinoma (zollinger-elison)
Local
-removed surgically
Metastatic
-Lifelong PPI
-Unresectable
Best initial test for Diabetic Gastroparesis
Upper endoscopy or Abd CT
-rule out masses
Most accurate test for Diabetic Gastroparesis
Bolus of food tagged with Technetium
Treatment of Diabetic Gastroparesis
Diet modification
Metoclopramide
Erythromycin and antiemetics
Gastric electrical stimulation
-gastric pacemaker
