H Pylori and Gastric Disease

Question 1

What is meant by the diagnosis ‘dyspepsia’

Answer 1

indigestion

Question 2

symptoms that can be incorporated by dyspepsia

Answer 2

• pain/ discomfort in upper abdomen
• retrosternal pain
• anorexia
• nausea
• vomitting
• bloating
• fullness
• early satiety (can’t eat any more)
• heart burn

Question 3

what are the main groupings of causes of dyspepsia?

Answer 3

• upper GI
• Hepatic causes
• Gallstones
• pancreatic
• lower GI
• coeliac
• psychological
• drugs
• other systemic disease (e.g. cardiac, metabolic)

Question 4

when should a case of dyspepsia be referred for an endoscopy?

Answer 4

A - anorexia 
L - loss of weight
A - anaemia
R - recent onset >55 years, or persistent    . . ....  despite treatment
M - Melaena/ haematemesis (GI bleeding) 
S - swallowing problems (dysphagia)

Question 5

describe an upper GI endoscopy

Answer 5

• diagnostic and therapeutic upper GI endoscopy
• local anaesthetic or rarely sedation
• day case
• fasted
• consent
• risk (perforation, bleeding etc.)

Question 6

describe helicobacter pylori

Answer 6

• gram negative
• spiral shaped
• microaerophilic
• flagellated
• infects 50% of world population

Question 7

where can H Pylori colonise

Answer 7

gastric type mucosa (can’t just stay in stomach cause of acid)

Question 8

where does H Pylori reside

Answer 8

in the surface mucous layer and doesn’t penetrate the epithelial layer

Question 9

what is the outcome of h. pylori infection dependant on

Answer 9

• site of colonisation
• characteristics of bacteria
• hosts factors (e.g. genetic susceptibility and other environmental factors e.g. smoking)

Question 10

PPI

Answer 10

Proton Pump Inhibitor

Question 11

Function of PPI in alimentary track

Answer 11

Inhibit gastric acid secretion in treatment of ulcers and GI reflux