H. Pylori + Gastric Disease Flashcards
What are the functions of the stomach?
Storage Start digestion Acid secretion Secretion of intrinsic factor Secretion of enzymes (e.g. pepsin)
What is dyspepsia?
General term to describe a group of symptoms causing pain/discomfort in upper abdomen
Describe the 9 symptoms than can be included in dyspepsia
- pain/discomfort in upper abdomen
- retrosternal pain
- anorexia
- nausea
- vomiting
- bloating
- fullness
- early satiety
- heartburn
What percentage of people have dyspepsia?
80%; majority with no underlying disease
What medical professionals generally treats dyspepsia symptoms?
GP; community pharmacist
What are 4 upper GI causes of dyspepsia?
Peptic ulcer, gastritis, non-ulcer dyspepsia, gastric cancer
Name 3 other organ related cause of dyspepsia?
Hepatic causes
Gallstones
Pancreatic disease
Name 2 lower GI causes of dyspepsia?
IBS, colonic cancer
Name 3 other causes of dyspepsia
Coeliac, psychological, drugs
What types of systemic disease cause dyspepsia?
Metabolic (high Ca; diabetes)
Cardiac (retrosternal heaviness - IHD)
What is the acronym for red flag symptoms for when to refer for endoscopy?
Anorexia
Loss of weight
Anaemia - iron deficiency (could be lesion bleeding in upper GI)
Recent onset > 55 years or persistent despite treatment (could be cancer)
Melaena/haematemesis
Swallowing problems/dysphagia
What are the conditions of an upper GI endoscopy?
local anaesthetic/sedation, day case, fasted, consent
What are the risks of an upper GI endoscopy?
1:2000 perforation, bleeding, reaction to drugs given
What are the 4 elements of investigations into someone with dyspepsia?
History + examination
Bloods
Drug history
Lifestyle
What bloods might you request for someone with dyspepsia?
FBC, ferritin, LFTs, U+Es, calcium, glucose, coeliac serology/serum IgA
What drugs should be asked about in drug history of someone with dyspepsia?
NSAID (brufen, nurofen, ibruprofen, naproxen)
Steroids
Bisphosphonates (osteoporosis - large tablet)
Ca antagonists
Nitrates
Theophyllines
remember OTC
What aspect of lifestyle should be explored?
Alcohol, diet, smoking, exercise, weight reduction
What type of bacteria is H. pylori?
gram neg, microaerophillic, flagellated
Where can H. pylori only colonise?
Gastric type mucosa (stomach) - surface mucous layer not epithelial layer; burrows in to get away from gastric acid
What is H. pylori categorised as?
Type I carcinogen
What is H. pylori effect on epithelial cells?
Cannot go through them but has an effect on those which sit close to it
What is H. pylori mechanism?
It is urease positive - breaks down surrounding substrates and creates a halo of alkilinity