Helicobacter Pylori and Gastric Disease Flashcards
What parts of the GI tract are considered to be upper GI tract?
Oesophagus
Stomach
What parts of the GI tract are considered to be lower GI tract?
Small intestine
Large intestine
What are the layers of the muscularis externa of the stomach?
Oblique muscle
Circular muscle
Longitudinal muscle
What are the folds in the stomach called?
Rugae
What are the functions of the stomach?
Food storage
Initial digestive processes
Acidic environment for defence
Secretion of gastric acid and gut hormones, intrinsic factor and pepsin
What is dyspepsia?
Describes a group of symptoms, pain or discomfort in the upper abdomen (indigestion)
What are the symptoms under the umbrella term dyspepsia?
Upper abdominal discomfort
Retrosternal pain
Anorexia
Nausea
Vomiting
Bloting
Fullness
Early satiety
Heartburn
What are the 2 categories of dyspepsia?
Organic or functional
What are examples of diseases that can cause dyspepsia?
Upper GI:
GORD
Peptic ulcer
Gastritis
Non ulcer dyspepsia
Gastric cancer
Gallstones
Pancreatic disease
Coelic disease
Drugs
Psychological
What are the steps you should follow if a patient presents with dyspepsia?
1) History and examination
2) Bloods
3) Drugs history
4) Lifestyle
What bloods should be done for a patient presenting with dyspepsia?
FBC
Ferritin
LFTs
U&Es
Calcium
Glucose
Coeliac serology/serum IgA
What do U&E blood tests measure?
Urea
Electrolytes (sodium and potasium) and creatinine
What drugs should be asked about when a patient presents with dyspepsia?
NSAIDs
Steroids
Biphosphonates
Ca antagonists
Nitrates
Theophyllines
What lifestyle factors should be asked about when a patient presents with dyspepsia?
Alcohol
Diet
Smoking
Exercise
Weight
When should a patient be refered for an endoscopy once they present with dyspepsia?
Anorexia
Loss of weight
Anaemia
Recent onset (>55 years or persistent despite treatment)
Melaena/haematemesis or mass
Dysphagia
What is the production of dark, sticky faeces containing partly digested blood called?
Melaena
What is the vomiting of blood called?
Haematemesis
What are difficulties swallowing called?
Dysphagia
What are some risks of getting an upper GI endoscopy?
Perforation
Bleeding
Reaction to drugs given
What are the options for anaesthetic for an upper GI endoscopy?
Local anaesthetic (throat spray) or sedation
Should food be eaten before an upper GI endoscopy?
No, the patient should be fasted
What are characteristics of helicobacter pylori?
Gram negative
Spiral-shaped
Microaerophilic
Flagellated
What is a microaerophilic organism?
One that requires oxygen to live
What percentage of the world population is infected with helicobacter pylori?
50%
When is helicobacter pylori acquired?
Childhood
Where does helicobacter pylori colonise?
Gastric type mucosa
Resides in surface mucous layer and does no penetrate the epithelial layer
Why does helicobacter pylori not always evoke the immune response in underlying mucosa?
Dependant on host genetic factors
What does the clinical outcome of an infection with helicobacter pylori depend on?
Site of colonisation
Characteristics of bacteria
Host factors such as genetic susceptibility
Environment factors such as smoking