Gastric Disease: Gastritis, Peptic Ulcer, Gastric Outlet Obstruction

Question 1

What causes gastritis

Answer 1

Autoimmune - bodies cells attack parietal cells
Bacterial - H. pylori
Chemical - NSAIDS or bile reflux into the stomach

Question 2

How is gastritis diagnosed

Answer 2

histologically by biopsy

Question 3

What can cause a Peptic Ulcer

Answer 3

H pylori
NSAIDS or steroids
Smoking or alcohol
Systemic illness - stress ulcers

Question 4

Symptoms of Peptic ulcer

Answer 4

epigastric pain 
nocturnal pain 
hunger pain 
back pain 
N&V
Haematemesis / melaena / anaemia if bleeding
weight loss

Question 5

Treatment of peptic ulcer

Answer 5

Eradication therapy
Antacid medication: PPI’s or H2RA
Stop NSAIDS
Surgery only if complications

Question 6

Complications of Peptic ulcer

Answer 6

Acute bleeding - melaena / haematemesis
Chronic bleeding - anaemia 
perforation 
fibrotic stricture 
gastric outlet obstruction

Question 7

Presentation of Gastric Outlet Obstruction

Answer 7

Recurrent vomitting 
Early satiety 
Abdominal distension 
Weight loss
Gastric splash 
Dehydration

Question 8

What is found on investigation in Gastric outlet obstruction

Answer 8

Metabolic alkalosis

Low Cl, Na, K levels - renal impairment

Question 9

Diagnosis of Gastric outlet obstruction

Answer 9

UGIE after prolonged fast or aspiration of gastric contents

Allows identification of cause such as ulcer, stricture, cancer etc.

Question 10

Treatment of gastric outlet obstruction

Answer 10

Endoscopic balloon dilation

Surgery

Question 11

When and why should a repeat endoscopy be done for a peptic ulcer

Answer 11

After 8 weeks as they can sit over gastric carcinoma