gastric acid disorders and ulcerations Flashcards
what is dyspepsia?
-upper abdominal pain, heart burn, gastric reflux, bloating
-nausea and vomiting
what are some urgent referrals symptoms for dyspepsia?
gastrointestinal bleeding
aged 55 years+
unexplained weight loss
dysphagia
what are the 2 types of dyspepsia?
-uninvestigated
-functional
what is uninvestigated dyspepsia?
-PPI for 4 weeks first
-test for H.pylori if PPI didn’t work treat if positive
what is the treatment for functional dyspepsia? (investigated but no cause present)
-test for H. Pylori treat positive
not infected: 3 weeks of PPI or H2 receptor antagonist
how do you test for H.Pylori?
-diagnosed with a urea (13C) breath test or stool helicobactor antigen test (SAT)
-ppi should have been stopped 2 weeks before test
-antibiotics should have stopped 4 weeks before test
how is H pylori treated?
triple therpY: PPI and 2 of the antibiotics
-PPI twice daily
-Amoxicillin 100mg twice daily (use other 2 in penicillin allergy)
-clarithromycin 500mg twice daily for 7 days
-metronidazole 400mg twice daily for 7 days
what can increase the chances of gastro-oesophageal reflux disease?
-consuming fatty food
-preganancy
hiatus hernia
-family history
-stress and anxiety
obesity
-drug Side effects
-SMOKING
-ALCoHOL
what drug side effects cause GORD?
(a/b-blockers, CCB, anticholinergics, bentos,bisphosphonates, corticosteroids, NSAIDs, nitrates and TCAs) -looses up the sphincter
what should be offered first for GORD?
lifestyle advice
what lifestyle advice can be given for GORD?
-healthy eating
-weight loss (if obese)
-avoiding any trigger foods
-eating smaller meals
-eating evening meal 3-4hrs before bed
-raising the head of the bed
-smoking cessation
-reducing alcohol consumption
what is the treatment for GORD?
Medicine review, some can exacerbate GORD
-UNINVESTIGATED good TREATED THE SAME AS UNINVESTIGATED DYSPEPSIA
-confirmed GORD treatment with 4-8weeks of PPI
HOW DO YOU TREAT good IN PREGNANCY?
dietary and lifestyle
antacid or an alginate
omeprazole or ranitidine
what are some antacids and their effects?
-magnesium-containing antacids= laxative
-aluminium-containing antacids= constipation
-calcium-containing= indices rebound acid secretion
how do simeticone work?
-antifoaminng agent added to antacid leading to relived flatulence