Peptic Ulcer Disease Flashcards
Symptoms of dyspepsia
Epigastric pain or burning, postprandial fullness, early satiety
When is dyspepsia more common?
H.pylori infection or NSAID use
Causes of dyspepsia
Peptic ulcer disease, drugs (NSAIDs, COX2 inhibitors), gastric cancer
Examination of dyspepsia - uncomplicated vs complicated
Uncomplicated - epigastric tenderness only
Complicated - cachexia, mass, evidence of gastric outflow obstruction, peritoneum
What criteria is used to diagnose functional dyspepsia
Rome III diagnostic criteria
Rome III diagnostic criteria
- Rome III diagnostic criteria – presence of at least one of the following:
o Bothersome postprandial fullness
o Early satiation
o Epigastric pain
o Epigastric burning - And no evidence of structural disease that is likely to explain the symptoms
Most common cause of peptic ulcer disease
H.pylori
H.pylori:
- When is it acquired?
- What is it?
- Spread
- Infancy
- Gram -ve microaerophilic flagellated bacillus
- Oral-oral, faecal-oral
Diagnosis of H.pylori infection
Gastric biopsy, urease breath test, faecal antigen test, serology (IgA antibodies)
What does a gastric biopsy for H.pylori infection involve?
Urease test, histology, culture/sensitivity
What colour will a urease test go if H.pylori positive and H.pylori negative
Positive = red/pink Negative = yellow/orange
Treatment for peptic ulcer disease
All patients tested for H.pylori infection, antisecretory therapy, withdraw NSAIDs, change lifestyle, surgery infrequently
Eradication therapy for H.pylori - triple therapy
PPI + amoxycillin 1g bd + clarithromycin 500mg bd
OR
PPI + metronidazole 400mg bd + clarithromycin 250g bd
How long is triple therapy given for?
1 week
Complications of peptic ulcer disease
Anaemia, bleeding, perforation, obstruction - fibrotic scar
