Gastro-duodenal Disease Flashcards
What is dyspepsia?
Pain or discomfort in the upper abdomen
When should a patient with dyspepsia be referred for endoscopy?
Weight loss
Anaemia
Malaena/ Haematemesis
Dysphagia
What investigations should be done for dyspepsia?
Bloods
Drug history
Lifestyle
What is helicobacter pylori?
Gram negative, spiral shaped, flagellated bacteria
Where does helicobacter pylori colonise
Gastric type mucosa (does not penetrate further)
How are helicobacter pylori infections diagnosed?
Serology
Urea breath test
Stool antigen test
Biopsy
What is gastritis?
Inflammation in the gastric mucosa
What are the causes of peptic ulcers?
Helicobacter pylori infections
NSAIDS
Smoking
What are the clinical features of peptic ulcers?
Epigastric pain Back pain Nausea Weight loss Maleana/ Haematemesis if ulcers bleed
How are peptic ulcers treated?
Eradication therapy using proton pump inhibitors or H2R antagonists (H Pylori)
Stop NSAIDS and smoking
What is the eradication therapy for helicobacter pylori infections?
Triple therapy for 7 days (clarithromycin, amoxycillin, proton pump inhibitors)
What are the complications of peptic ulcers ?
Acute bleeding leading to malaena and haematemesis
Chronic bleeding leading to iron deficiency anaemia
Perforation
Fibrotic stricture
What is gastric outlet obstruction?
Consequence of any disease process that produces a mechanical impediment to gastric emptying
What are the symptoms of gastric outlet obstruction?
Vomiting Early satiety Abdominal distension Weight loss Metabolic alkalosis
What are the clinical signs of gastric outlet obstruction?
Low Cl, Na and K in bloods
Renal impairment
