gastric reflux( heartburn) Flashcards
what is heartburn?
acidic contents of stomach escape back into the oesophagus due to weakened or malfunctioned sphincter.
symptoms of heartburn
severe pain in upper chest, acid taste in mouth, stabbing pain, burning in back of throat, excess acid, burning pain rising up throat.
gastric reflux causes
eating fatty foods, chocolate, alcohol,coffee and smoking. lifting or bending from waist. pregnant women and dyspepsia.
danger signals of heartburn
pain radiating down arm (cardiac), pain disturbs sleep ( peptic ulcer), over 50+ with new or worsening symptoms (cancer), bleeding, weight loss, anaemia, pain or difficulty swallowing, vomiting, breathlessness, regular symptoms ( more than twice a week).
causes of chest pain
acid reflux can produce chest cramps that can radiate to neck, shoulder and arm. angina can cause intense crushing which radiates to jaw and arm. heart attack can cause crushing pain with nausea, vomiting shortness of breath, ashy skin, clamminess and sweating.
symptoms of oesophagitis
difficulty in swallowing, pain on swallowing, blood stained vomit or stools
symptoms of duodenal ulcers
hunger pains, relief by eating and then recurring hours after, causes sufferes to wake, blood stained vomit or stools
symptoms of a peptic ulcers
localised in pain, nausea, worse after food, salivation, loss of appetite, weight loss and bloating
symptoms of gastric cancer
weight loss, loss of appetite, anaemia and blood in stools or vomit
treatments for heartburn and indigestion
raising bed, stopping smoking and reducing alcohol and caffeine intake, cutting out spicy oily foods,antacids,alginates, controlling stomach acid and proton pump inhibitors.
what are antacids?
work by neutralising excess acid in the stomach
types of antacids
magnesium salts, aluminium salts, sodium salts and calcium salts.
magnesium salts
tends to cause diarrhoea although long acting and very effective
aluminium salts
lines the stomach and acts as a mechanical barrier to the acid. tends to cause constipation so combining this and magnesium cancels the problem out.
sodium salts
fast but short acting. may cause wind for relief, should be avoided by those with kidney problems, heart problems,and high blood pressure. pregnant women can use but only through recommendation.
calcium salts
fast acting and long acting. can cause constipation and rebound excess acid with high doses. tabs should be chewed or sucked and needs to be a gap of at least two hours between taking antacids and medications.
what are alginates ( rafting agents) ?
when alginates come into contact with stomach acid, they produce a thick substance that floats on the surface of stomach contents preventing them from escaping back up the oesophagus.
alginates - gaviscon or peptac
take after food, medications should always be taken before otherwise action will be delayed. less effective when people are laying down. safe for pregnancy and breastfeeding. cautions with kidney problems, heart problems and high bp.
ways to control stomach acid
ranitidine
what is ranitidine?
h2 agonist. effective at reducing the production of stomach acid. can last up tp 12 hours so good for night symptoms. 16+. used for max of 14 days. max dose of 4 tabs.
types of proton pump inhibitors
omeprazole, pantoprazole and esomeprazole.
what is a proton pump inhibitor?
interferes with the way stomach acid is produced by the body. they stop the parietal cell from producing hydrochloric acid
how to take omeprazole
initial dose is 2 10mg tabs taken twice daily, usually in the morning. can be used for four weeks without a prescription.
how to take pantoprazole
20mg tab once daily. may take 3-7 days for full effects. can be used for two weeks without a prescription. not suitable for pregancy, breastfeeding. 18+
