Peptic ulcer disease Flashcards
briefly describe what causes peptic ulcer disease
a disruption in the balance between the gastric acid and alkaline fluid in the stomach, leads to mucosal injury and formation of peptic ulcers
describe the risk factors for developing peptic ulcers
predominantly middle-aged men, NSAIDs, smoking, helicobactor pylori infection, Zolinger-Ellison syndrome
what is the more common type of peptic ulcer disease
duodenal ulcer
what does dyspepsia mean and what it is often used to describe
means disturbed digestion(indigestion), can also cover nausea/vomiting, bloating/burping, epigastric discomfort
describe what worsens and what relives pain in gastric ulcers
epigastric pain worsened by eating(increased HCl production), and eased by antacids + lying flat
describe what relieves epigastric pain caused by duodenal ulcers
relieved by eating
describe how a ruptured duodenal ulcer presents
rectal bleeding/melaena
melaena = blood in faeces
describe how a ruptured gastric ulcer presents
haematemesis
what are gastric ulcers associated with and what is a sign of that association
associated with gastric malignancy
sign = Virchow’s node
where is Virchow’s node seen
left supraclavicular fossa
what ‘alarm’ symptoms must be asked about when a patient presents with dyspepsia (4)
abdominal mass, haematemesis, rectal bleeding/melaena, weight loss
when would a patient presenting with dyspepsia be tested for H. pylori
after 1 month of uncomplicated dyspepsia with no relief from antacids or weight loss
what tests can be done for H. pylori
breath test or stool antigen
how does the H. pylori test affect pharmacological treatment of peptic ulcers
must be done 2-4 weeks since last PPI(protein pump inhibitor)/antibiotic dose
if the H. pylori test is +ve, what is the first line therapy for patients with no penicillin allergy
Triple therapy: PPI
+ amoxicillin
+ either metronidazole or clarithromycin
