gastric conditions Flashcards
why may gastric conditions occur (4) ?
infection
excess gastric production
inflammation
cancer
what infection mainly causes gastric cancer ?
H. Pylori infection
what is the pathway for gastric cancer ?
infection
chronic gastritis
metaplastia
dysplasia
carcinoma
what are risk factors for gastric cancer ?
A blood group
smoking
what important histology is present in gastric cancer ?
signet ring cell
what are the main clinical features of gastric cancer (6) ?
dyspepsia
epigastric pain
haematemesis/melanea
anorexia and weight loss
nausea
progressive dysphagia
how would you investigate for gastric cancer ?
endoscopy with biopsy
for staging CT investigation after
how would you manage gastric cancer ?
gastrectomy
depending on site: proximal: total resection, distal: partial resection
what is peptic ulcer disease ?
breach of GI mucosa by acid/pepsin attack
what causes peptic ulcer disease ?
H. pylori (gram -ve bacteria)
NSAIDs
what are common examples of NSAIDs ?
ibuprofen
naproxen
where do you get peptic ulcer disease ?
mostly duodenal
gastric
how can you tell where the peptic ulcer is present ?
duodenal = pain relived by eating
gastric = pain worse when eating
what are common symptoms of peptic ulcer disease?
burning epigastric pain
nausea & dyspepsia
how would you investigate for peptic ulcers ?
Urea breath test or stool antigen test to diagnose H. pylori
endoscopy (if H.plyrori is negative and trying to exclude cancer)
how would you treat peptic ulcer disease?
antacids
H2 antagonists
PPI
H.Pylori eradication therapy
what is the H.Pylori eradication therapy ?
Triple therapy - 7 day course
PPI + amoxicillin + metronidazole
if resistance to metronidazole:
PPI + amoxicillin + Clarithromycin
what are complications of peptic ulcer disease ?
upper GI bleed
perforation = peritonitis and scarring
malignancy
what is gastroparesis ?
delayed gastric emptying (NOT DUE TO OBSTRUCTION)
what causes gastroparesis ?
idiopathic
diabetes mellitus
medications
what are clinical features of gastroparesis ?
bloating
early satiety
nausea and vominting
weight loss
abdominal pain
how would you investigate for gastroparesis ?
oesophageal manometry
how would you treat gastroparesis ?
removal of precipitating factor
lifestyle change: liquid Diest (eat little but often)
gastric pacemaker
