Gastric Acid Disorders + Ulceration Flashcards
1
Q
what is dyspepsia
A
indigestion
2
Q
symptoms of dyspepsia
A
- upper abdominal pain
- heartburn
- gastric reflux
- bloating
- N+V
3
Q
red flags / urgent referral symptoms of dyspepsia
A
- GI bleeding
- 55+
- unexplained weight loss
- dysphagia
4
Q
uninvestigated dypepsia tx
A
- PPI for 1st 4 weeks
- test for H.pylori if PPI didn’t work
5
Q
investigated but no cause present
functional dyspepsia
recurrent
A
- test for h.pylori
- not infected = 3 weeks of PPI or H2 receptor antagonist
6
Q
what is most common cause of peptic uclers
A
h.pylori
7
Q
how is H.pylori diagnosed
A
- with urea (13C) breath test or Stool Helicobacter Antigen Test (SAT)
8
Q
what should be stopped before testing for h.plyori
A
- PPI stopped 2 weeks before
- antibiotics 4 weeks before
9
Q
tx of h.pylori
A
- PPI = BD
- Amoxicillin = 1000mg BD
- Clarithromycin = 500mg BD
- Metronidazole = 400mg BD
10
Q
Duration of H.pylori tx
A
7 days
11
Q
Gastro-Oseophageal Reflux Disease
urgent / red flags of GORD
A
- GI bleeding
- 55+
- unexplained weight loss
- dysphagia
12
Q
what increases GORD symptoms
A
- fatty foods
- pregnancy
- hiatus hernia
- family history
- stress, anxiety
- obesity
- medication s/e
- smoking + alcohol
hiatus hernia = part of stomach moves to chest
13
Q
which medications increases GORD as a s/e
A
- ablocker
- bblocker
- CCB
- anticholingeric
- benzo
- bisphosphates
- corticosteroids
- NSAIDs
- nitrates
- TCA
14
Q
GORD 1st line
offer lifestyle advice first
A
- healthy eating
- weight loss (obese)
- avoid triggering food
- smaller meals
- evening meals 3-4hr before sleep
- raising head of bed
- smoking cessation
- less alcohol consumption
15
Q
uninvestigated + confirmed GORD
tx of GORD
A
- medication review if taking exacerbating drugs
- uninvestigated GORD = 4WK PPI + test for h.pylori
- confirmed GORD = 4-8WK of PPI
