Gastritis Flashcards
what is gastritis?
Inflammation of the stomach lining (mucosa membrane)
7
Gastritis causes
H. pylori
NSAIDs
Stress
Alcohol
Caffeine
Smoking
Spicy foods
what is PUD?
ulceration of the mucosa of the stomach (gastric ulcer) or the proximal duodenum (duodenal ulcer)
duodenal ulcer >common
PUD pathophysiology
Mucosa layer protects stomach from acid/contents and secretes HCO3-. disruption to this layer causes an increase in acid which can leads to ulceration.
PUD Sx
Epigastic pain
Nausea/Vomiting
Dyspepsia (bloating, early saiety)
PUD clinical presentations
UGI bleed:
haematemesis
coffee ground vomit
malaena
reduce Hb on FBC
PUD Ix
- Endoscopy w/ CLO test (rapid urease test for H. pylori), Bx during to exclude malignancy
- H.pylori: 13C-urea breath/stool Ag test
PUD Mx
- Lifestyle modifications: avoid stress, reduce caffine, spicy food, acidic food
Stopping NSAIDs, Aspirin, steroids, bisophonates - Full dose PPI for 4-8/52 + f/u appt
- if proven PUD: Arrange Endoscopy 6-8/52 post Tx to confirm healing
- Low dose PPI for prevent if Sx recur
Triple Therapy, BD for 7/7
H.pylori eradication
- PAC: PPI , Amox 500mg , Clari 500mg
- Penicillin allergy, PCM: PPI, Metron 400mg, Clari 500mg
- Repeat 1st line 13C-urea breath, 2nd line stool Ag
Differentiating gastric/duodenal ulcers
Duodenal: Pain improves immediately after eating
Gastric: Pain worsens after eating (may have WL due to fear to eat)
3 complications
Gastritis Complications
- UGI bleed: Fe def. anaemia/haemorrhage
- Perforation: can lead to acute peritionitis (Mx: laparoscopic repair)
- pyloric stenosis: strictures causes narrowing of the stomach outlet-gastric outlet obstruction (Mx: ballon dilation)
H.pylori Mx for: re-test +VE post 1st line Tx
Triple Therapy, BD for 7/7(PPI + w/ the Abx NOT taken for the 1st time
How long do you have to stop taking PPI prior to H.pylori testing?
Stop PPI for 2/52
How long do you have to stop taking Abx prior to H.pylori testing?
Stop Abx for 4/52
