Peptic Ulcer Disease + Gastric Cancer Flashcards
what is a peptic ulcer
break in the lining of the GI tract, extending through the muscle layer
main risk factors for peptic ulcers
H.Pylori NSAID use smoking alcohol Zollinger-Ellison syndrome
what is H.Pylori
gram -ve spiral shaped bacillus
- induces an inflammatory response in the mucosa leading to ulceration
presentation of peptic ulcer disease
epigastric/retrosternal burning pain
nausea
bloating
what is the difference in presentation between a duodenal ulcer and a gastric ulcer
duodenal - pain is relieved by eating
- pain onset 2-3 hours post eating
- might gain weight due to over eating to relieve pain
gastric- pain is worsened by eating
- comes on post prandial
- lose weight as avoid eating due to pain
- vomiting may also relieve pain
non-invasive testing for peptic ulcer disease
H.Pylori testing as either:
- urea breath test
- serum antibodies to H.Pylori
- stool antigen test
patients need to stop any current PPIs for 2 weeks prior to testing
which patients should receive an OGD
Patients with new onset dysphagia
Age >55 with weight loss + abdo pain / reflux / dyspepsia
Patients not-responding to PPI therapy
what is Zollinger-Ellison syndrome
triad of:
- severe peptic ulcer disease
- gastric acid hyper secretion
- gastrinoma
lifestyle modifications for peptic ulcer disease
smoking cessation
weight loss
reduce alcohol intake
avoidance of NSAIDS
What drug is given to treat peptic ulcer disease
a PPI e.g omeprazole
- given for 4-8 weeks then reassessed for resolution of symptoms
H.Pylori eradication therapy
triple therapy: PPI, Amoxicillin and clarithromycin /metronidazole for 7 days
most common type of gastric cancer
adenocarcinoma
risk factors for gastric cancer
Male
H.Pylori
Smoking
Alcohol
Symptoms of gastric cancer
dyspepsia (indigestion) dysphagia (difficulty swallowing) early satiety malena nausea
what is Troisiers sign
palpable left supraclavicular node (Virchows node)
- gastric cancer
