Gastroenterology

Question 1

What is the difference in pain between gastric and duodenal ulcers

Answer 1

• Gastric Ulcer → pain directly after meals (may lead to weight loss)
• Duodenal Ulcer → pain couple hours after eating (pain may be relieved by eating) (may lead to weight gain)

Question 2

What are symptoms of gastritis

Answer 2

nausea, vomiting & loss of appetite (leading to weight loss)

pain after meals

Question 3

What is the management for peptic ulcer disease

Answer 3

Lifestyle → reduce smoking and alcohol intake

Medical (H.Pylori +ve) → triple therapy (PPI (Omeprazole) + Amoxicillin + Clarithromycin → if penicillin allergy then Metranidazole for amoxicilin)

Medical (H.Pylori -ve) → stop drug causing ulcer (ie. NSAID) and offer 4-8 weeks of PPI Therapy (Omeprazole 20mg)

Question 4

What is the follow up plan for Peptic ulcer disease

Answer 4

For gastric ulcers, repeat endoscopy 6-8 weeks later to ensure ulcer healing and rule out malignancy.

For duodenal ulcers, repeat test (urea breath test) for h.pylori 6-8 weeks later is usually sufficient.