Peptic ulcer disease and gastritis Flashcards
What is PUD
ulceration of GI tract caused by exposure to gastric acid and pepsin
What are causes of PUD
H.pylori
NSAIDs
alcohol
bisphosphonates
smoking
Zollinger-Ellison syndrome
What is difference between PUD and gastritis
in PUD - only gastric and duodenal whereas in gastritis whole stomach lining is inflamed
How may someone present
epigastric pain that can be pointed to
relieved by antacids
nausea and vomiting
What may someone present with if they have gastric PUD
pain directly after meals
weight loss
What may someone present with if they have duodenal PUD
relieved by eating , pain couple hours after meals
weight gain
What are some complications of PUD
haematemesis
Melaena
What are first line investigations for PUD
Urea 13 breath test, stool antigen test for H.pylori
Erect CXR- if suspecting perforation
What are other investigations for PUD
upper GI endoscopy and biopsy
Blood antibody test
- IgG antibody against H.pylori confirms exposure
CLO test - red colour change if H pylori present
What are some investigations for gastritis
H.pylori tests
What is lifestyle management
stop NSAIDs
reduce smoking
reduce alcohol
What is treatment if H.pylori is positive
7 day course Triple therapy with PPI and 2 antibiotics amoxicillin/clarithromycin/
metronidazole
then retest at 6-8 weeks
What is treatment if H.pylori negative
Stop NSAID or causative drug
4-8 week PPI therapy
What is management if perforated ulcer
Blatchford risk score
Transfuse
Therapeutic endoscopy
When doing carbon 13 urease test what should be considered
PPI meds need to be stopped as can result in false postive
