minor ailments of upper GI tract

Question 1

what is the definition of indigestion (dyspepsia) ?

Answer 1

a persistent or recurrent pain or discomfort in the upper abdomen due to a disorder of digestive function

Question 2

what is the definition of gastro oesophageal reflex disease (heartburn)

Answer 2

a digestive disorder involving the lower oesophageal sphincter causing the reflux of gastric contents particularly acid in the oesophagus

Question 3

what are symptoms of indigestion?

Answer 3

• feeling of fullness after eating
• heartburn
• abdominal distension - bloating
• flatulence - burping/passing wind
• acidic taste
• nausea and vomiting

Question 4

what are danger symptoms of indigestion?

Answer 4

• persistent abdominal pain
  -anorexia
• unexplained weight loss
• blood in vomit or black tarry stools (bleed internally)
• severe pain in upper or lower abdomen
  difficulty swallowing

Question 5

after how long having indigestion should you refer?

Answer 5

5 days

Question 6

what are treatment options of indigestion?

Answer 6

Antacids eg. rennies
- physically neutralise the stomach
best one hour after meals as gastric emptying is slowed (don’t use long term as body starts to compensate for reduction and starts producing more acid)

Deflatulents - break up and release trapped wind eg. peppermint oil, dimethicone and simeticone

Histamine H2 antagonists eg. famotidine
- reduce amount of acid produced in stomach
-both basal and stimulated gastric acid secretion are inhibited reducing both the acid content and to a smaller extent

Proton pump inhibitors eg omepazole
- specific inhibitor of acid pump in parietal cells

Question 7

what are some non-drug counselling points for indigestion?

Answer 7

• eat small meals often - eating too much or too fast aggregates
• eat with mouth closed
• lose weight
• reduce alcohol consumption
• stop smoking
• avoid trigger factors eg spicy food
• try and avoid stressful situations

Question 8

what are the symptoms of GORD?

Answer 8

• burning pain in the chest between the stomach and throat with or without pain and/or flatulence

Question 9

what are causes of GORD?

Answer 9

diatery habits
lifestyle habits
medical causes

Question 10

what are danger symptoms of GORD?

Answer 10

difficulty swallowing - dysphagia
- severe pain radiating to back and arms
- pain aggregated by exercise

Question 11

after how long having GORD should you refer?

Answer 11

longer than a week

Question 12

what is some non-drug advice for GORD?

Answer 12

• avoid bending
• raise head of bed
• dietary
• health promotion

Question 13

what are the treatments available for GORD?

Answer 13

• as for indigestion to neutralise/ reduce acid production but also have rafting agents

Rafting agents work by floating on top of the stomach contents eg gaviscon