Stomach Disorders Flashcards
What is gastritis?
superficial inflammation/irritation of the stomach with mucosal injury
What is gastropathy?
Mucosal injury without evidence of inflammation
What is the pathologic causes of gastritis?
imbalance between aggressive (increased) and protective (decreased) mechanisms of gastric mucosa.
What are the most common causes of gastritis?
- H. pylori (most common!)
- NSAIDs/ASA (2nd most common)
- Acute stress (ICU pts)
What are the clinical manifestations of gastritis?
Patients are most commonly asymptomatic
If symptomatic —-> upper GI bleed (hematemesis, melena)
Epigastric pain, N/V
What is the diagnostic test of choice for gastritis?
Endoscopy and H.pylori testing
What is the management for H.pylori + gastritis or PUD?
CAP —> clarithromycin, amoxicillin, and a PPI
metronidazole if allergic to PCN
_____ ulcers are 4x more common than ______ ulcers.
Duodenal ulcers
Gastric ulcers
Gastric ulcers are more common in the ______.
elderly
What are the most common causes of peptic ulcers?
- H. pylori
- NSAIDs
- Zollinger Ellision syndrome
- ETOH
- smoking
- stress
Why do NSAIDs cause peptic ulcers?
because they inhibit prostaglandins, which are mucosal protective factors
How does a duodenal ulcer typically present?
Dyspepsia that is worse 2-5 hours AFTER meals and is better with meals and/or antacids
How does a gastric ulcer typically present?
Dyspepsia that is WORSE with meals (especially 1-2 hours after meals). Patients typically have weight loss b/c don’t want to eat.
What is the MOST common cause of an upper GI bleed?
Peptic ulcer disease!!!!
What is the gold standard diagnostic test for diagnosing PUD?
Endoscopy with biopsy (r/o malignancy especially with GU)
What are considered the “alarming” symptoms of PUD to suggest cancer?
- > 50 years
- dyspepsia
- hx of GU
- anorexia/weight loss
- anemia
- dysphagia
What is the gold standard diagnostic test for diagnosing H. pylori?
Endoscopy with biopsy and rapid urease test
When if the urea breath test utilized?
Testing for H. pylori if endoscopy can’t be done
Also used to confirm eradication after therapy**
H. pylori converts urea to _____.
carbon dioxide
Which test can be utilized to confirm eradication of H. pylori after therapy?
- Urea breath test
2. H. pylori stool antigen (HpSA)**
What is Zollinger-Ellison syndrome?
A gastrinoma (gastrin secreting tumor resulting in gastric acid hyper secretion leading to PUD)
What are the clinical manifestations of Zollinger-Ellison syndrome?
- multiple peptic ulcers that are refractory to tx
2. diarrhea
What are the best screening tests for Zollinger-Ellison syndrome?
- Fasting gastrin level —-> will be elevated
2. Secretin test —-> increase gastrin release (gastrin normally inhibited by secretin)
What is the management of Zollinger-Ellision syndrome?
Local —> surgical resection
Metastatic —> PPIs, surgical resection if involves liver
