Stomach Disorders

Question 1

Types of gastritis and how they are caused

Answer 1

Erosive (NSAIDs, ETOH, stress)

Non-erosive (H pylori, CMV, candida)

Question 2

Most sensitive diagnostic test for gastritis?

Answer 2

Endoscopy with biopsy

Question 3

Treatment of gastritis

Answer 3

• H2 blocker or PPI

- If H Pylori, then triple or quadruple therapy with PPI+abx+immunosuppressant

Question 4

Define peptic ulcer disease

Answer 4

• Erosion in gastric or duodenal mucosa

- Greater than 5 mm through muscularis

Question 5

What type of ulcers are MC in 55-70 yo?

Answer 5

Gastric

Question 6

Which type of ulcers are MC?

Answer 6

Duodenal

Question 7

Which type of ulcers are MC in younger patients?

Answer 7

Duodenal

Question 8

Causes of peptic ulcer disease

Answer 8

• NSAIDs
• H pylori
• Smoking

Question 9

Pain with gastric ulcer

Answer 9

Pain occurs with eating

Question 10

Pain with duodenal ulcer

Answer 10

Pain is relieved by eating but returns 2-4 hours postprandial

Question 11

Treatment of peptic ulcer disease

Answer 11

• PPI preferred
• Gastric 8 weeks tx
• Duodenal 4 weeks tx
• H pylori 14 day combo therapy

Question 12

Treatment of GERD based on severity

Answer 12

• H2 blockers for mild

- PPI for mod-severe

Question 13

Define Barrett esophagus

Answer 13

Normal esophageal epithelium replaced with columnar

Question 14

Who does Barrett’s esophagus affect?

Answer 14

Up to 10% GERD patients

Question 15

Define gastroparesis

Answer 15

Decreased or absent gastric motility WITHOUT mechanical lesion

Question 16

Causes of gastroparesis

Answer 16

DM, hypothyroid, post-op, Parkinson’s, MD/MS, idiopathic

Question 17

What is the definitive test of gastroparesis?

Answer 17

Gastric emptying study (nuclear): 60+% contents retained at 2 hours, 10+% contents retained at 4 hours

Question 18

Treatment of gastroparesis

Answer 18

• Eat smaller meals low in fiber, milk and gas-forming foods
• Reglan for acute event
• Erythromycin for prophylaxis