Peptic Ulceration Flashcards
What is the peptic ulceration?
It is is defined as a condition in which there is ulceration of the gastrointestinal mucosa
In which two areas of the gastrointestinal tract does peptic ulceration tend to develop?
Stomach
Duodenum
What is more common - gastric ulcers or duodenal ulcers?
Duodenal ulceration
What are the two general causes of peptic ulceration?
Increased secretion of gastric acid
OR
The breakdown of gastrointestinal mucosa
What are the six risk factors of peptic ulceration?
Helicobacter Pylori Infection
NSAID Administration
Steroid Administration
Smoking
Alcoholism
Stress
What is the most common risk factor of peptic ulceration?
Helicobacter Pylori Infection
What are the five clinical features of peptic ulceration?
Epigastric Pain
Nausea & Vomiting
Haematemesis
Abdominal Bloating
Heartburn
Do gastric ulcer features improve upon eating or worsen?
Worsen
Do duodenal ulcer features improve upon eating or worsen?
Improve
Which two investigations are used to diagnose peptic ulceration?
Helicobacter Pylori Testing
Endoscopy + Biopsy
What two tests are used to identify H.Pylori infection?
Urea Breath Test
Stool Antigen Test
What is the urea breath test?
It involves consumption of a urea containing liquid, which is a chemical broken down by H.Pylori into ammonia and carbon dioxide
After fifteen minutes, the volume of carbon dioxide exhaled is measured
What is a positive urea breath test?
Increased volumes of exhaled carbon dioxide
Which two drug classes can reduce the accuracy of the urea breath test?
Antibiotics within 4 weeks
Antisecretory drugs, such as PPIs, within 2 weeks
What is a stool antigen test?
It involves testing a stool sample for the presence of H.Pylori infection
What is the gold standard investigation used to diagnose peptic ulceration?
Endoscopy + Biopsy
How is endoscopy, with biopsy, used to investigate peptic ulceration?
The endoscopy is used to visualise peptic ulceration
The biopsies are conducted to exclude malignancy
What are the five conservative management options of peptic ulceration?
NSAID Cessation
Steroid Cessation
Smoking Cessation
Alcohol Cessation
Stress Reduction
What are the four pharmacological management options of peptic ulceration?
Antacid Drugs
Proton Pump Inhibitors (PPIs)
H2 Receptor Antagonist
Antibiotics
Name two antacid drugs used to manage peptic ulceration
Gaviscon
Rennie
When are antacid drugs used to manage peptic ulceration?
They are over the counter medications that patients can be advised to purchase
What is the mechanism of action of antacids?
They neutralise stomach acid and inhibit pepsin
How do antacid drugs treat peptic ulceration?
They can be administered to provide temporary symptomatic relief, however, don’t provide resolution of the underlying damage
Name two proton pump inhibitors (PPIs) used to manage peptic ulceration
Omeprazole
Lansoprazole
