GORD and gastric ulcers Flashcards

1
Q

what causes GORD?

A

the relaxation of the lower oesophageal sphincter (LOS) in absence of swallowing

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2
Q

what glands in the stomach release gastric acid?

A

oxyntic glands

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3
Q

how do H+ ions enter the stomach ?

A

CO2 diffuses into pareteral cells from the blood plasma and is hydrated into carbonic acid which dissociates into HCO3- and H+ ions, HCO3- enters the blood stream and H+ ions then move into the stomach via the H+/K+ proton pump transporter on the basolateral membrane, Cl- and K+ return to the lumen and HCl is made

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4
Q

give 3 positive regulators of gastric acid secretion?

A
  • acetylcholine
  • histamine
  • gastrin
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5
Q

describe the stages of gastric acid secretion?

A
  • cephalic: after the thought, smell or sight of food
  • gastric: when food enters the stomach, peptides in the food stimulate G cells which release gastrin to stimulate the release of HCL
  • intestinal: chyme enters the duodenum and activates D cells which secrete somatostatin and inhibits HCL increasing the PH
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6
Q

what is secreted by the pyloric region of the stomach?

A

both gastrin and mucus

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7
Q

what process inside the stomach creates a protective barrier?

A

secretion of alkaline rich fluid from the pyloric glands

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8
Q

what are the symptoms of GORD?

A

heartburn

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9
Q

what is a red flag symptom of GORD?

A

difficulty swallowing

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10
Q

what is the difference between gastric and duodenal ulceration?

A

gastric ulceration is caused by damage to the epithelium whereas duodenal ulceration is caused by an increase in acid production

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11
Q

what Bacteria caused peptic ulceration?

A

H.Pylori

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12
Q

how do NSAIDS (e.g ibuprofen) cause gastric ulcers?

A

NSAIDS decrease prostaglandin production, the role of prostaglandin is to inhibit gastric acid secretion and increase mucosa secretion

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13
Q

give 3 symptoms of gastric ulceration?

A
  • upper abdominal pain
  • feeling uncomfortably full
  • bloating
  • heartburn
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14
Q

give 2 red flag symptoms of gastric ulceration and what may be causing this?

A

unexplained weight loss, black or red or tarry stools, this may be caused by a GI bleed

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15
Q

give 2 non medical pieces of advice for GORD / ulceration?

A
  • weight loss
  • reduce fatty food intake
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16
Q

what is first line treatment for GORD and ulceration if no H.Pylori is present?

A

proton pump inhibitor e.g omeprazole, lansoprazole

17
Q

what dose of omeprazole and lansoprazole should be given for first line GORD/ULC treatment?

A

omeprazole = 20mg OD 4w
lansoprazole = 30mg OD 4w

18
Q

what is second line treatment for GORD and ulceration if no H.Pylori is present?

A

H2 receptor antagonist e.g famotidine twice daily

19
Q

what treatment is given for stomach ulceration when H.Pylori is present?

A
  • PPI
  • amoxicillin
  • clarithromycin
    (one PPI, 2 antibiotics)
20
Q

what antacid has laxative properties?

A

magnesium hydroxides

21
Q

what antacids have constipation risks?

A

aluminium hydroxides

22
Q

why does H.Pyori give patients ammonia smelling breath?

A

H.Pylori creates urease which breaks down urea into carbon dioxide and ammonia