Stomach and small intestine Flashcards
What are the causes of acute gastritis ?
– Alcohol
– Drugs such as NSAIDs, steroids
– Smoking
– Corrosives (acids and alkalis)
– Stress such as Shock, trauma, ischaemia, burns
– Uraemia
– Gastric irradiation
What is the presentation of acute gastritis ?
– Epigastric pain
– N&V
– Anaemia (from bleeding)
– Haematemesis
– Melaena
What is the pathophysiology of chronic gastritis ?
It is characterised by non-erosive chronic mucosal changes causing mucosal atrophy and epithelial metaplasia which has a risk of causing gastric carcinoma through dysplasia.
What are the three main types of chronic gastritis syndromes?
– Helicobacter-associated gastritis
– Autoimmune chronic gastritis
– Chemical / reflux gastritis
What is peptic ulcer ?
Peptic ulcers are open sores that develop on the inside lining of the stomach and the upper portion of small intestine.
What is gastric ulcer ?
These are ulcers that forms along the lesser curvature of the stomach and gastric antrum.
What is duodenal ulcer ?
These are ulcers at the first part of duodenal bulb.
What are erosive gastric ulcers ?
These are acute inflammation of the stomach that do not extend beyond the muscularis mucosae.
When to suspect cancer in GI ulcers ?
When the ulcers are present in atypical locations.
What are the causes of peptic ulcers ?
- Helicobacter Pylori
- NSAID use
- Idiopathic
- Zollinger-Ellison
- Viral Infections
- Cushing’s Ulcer
- Curling’s Ulcer
What is the clinical presentation of PUD ?
Patients commonly presents with epigastric pain worsened by food and hunger. They often have waterbrash and heartburn due to acid reflux or ulcers itself.
What are the ALARM symptoms of PUD ?
A- Anaemia
L- Loss of wieght
A- Anorexia and early satiety.
R- recent onset
M- Melina and hematemesis
What are the complications of PUD ?
– Gastric outlet obstruction
– Penetration and fistulisation
– Perforation peritonitis
What are the bedside investigations in PUD ?
– Vital Signs
– Blatchford Score
What are the blood works in PUD ?
- FBC and cross matching.
- urea
What is the radiological study in peptic ulcer ?
Erect CXR
What is the purpose of OGD in PUD?
It is both diagnostic and therapeutic. It can be used to do rapid urea test ( CLO test) . The OGD can be used to collect tissue for biopsy and H. pylori pathology. It can also be used for hemostasis in active ulcers.
What are the ivestigations in H. pylori ?
– Urea Breath Test
– Serum Antigen Test
– Stool Antigen Test
What is the pathophysiology of H.Pyllori gastric carcinoma ?
Chronic active superficial gastritis progress to atrophic gastritis. which will gradually cause intestinal metaplasia, dysplasia and finally gastric adenocarcinoma.
What are the preventive measures in PUD ?
smoking and alcohol cessation.
What is the key goal of acute an emergent management of PUD ?
The bleeding should be managed medically or endoscopically.