Peptic Ulcer Disease and Gastritis Flashcards
What is peptic ulcer disease (PUD)?
Break in lining of the stomach with obvious depth through the submucosa
Where are the ulcer more common?
DU»GU
What are RF for PUD?
- Hy pylori
- NSAIDs
- Smoking
- Increased/decreased gastric emptying
What are examples of gastric specific ulcers?
- Cushing (after brain trauma)
2. Curling ulcers (ischaemia and hypovolemia e.g. burns)
What is the classic presentation of PUD?
- Epigastric pain patient can point towards
- Key difference is gastric directly after meals, while duodenal manifests couple hours later
- Nausea and vomiting
- Mild weight loss
What is the gold standard investigation for PUD?
upper GI endoscopy (will reveal ulceration and can performa a biopsy of the tissue)
What other investigations are done?
- H pylori
2. Serum fastin gastrin level
What H pylori tests are done?
urea breath test and stool antigen test (retest after 6-8 weeks)
Why do you do serum fasting gastrin level?
What is the lifestyle management for PUD?
reduce smoking and alcohol intake
What is the medical therapy for H pylori positive?
triple therapy consisting of PPI + 2 antibiotics (normally amoxicillin or clarithromycin unless CI then metronidazole) – 7 day eradication
What is medical therapy for H pylori negative (possible drug induced ulcer)?
- stop drug causing ulcer immediately
2. offer 4-8 weeks of PPI therapy
What are possible complications of PUD?
- Haemorrhage
- Perforation
- Obstruction
What is the definiton of gastritis?
Histological presence of mucosal inflammation
What are RF for gastritis?
- H.pylori
- NSAIDS
- Alcohol
- Zollinger Ellison syndrome
- Menetrier disease
- Autoimmune
