Week 2.7 - Dyspepsia Flashcards
What is dyspepsia?
not a diagnosis but a broad description of symptoms
What symptoms are categorised as dyspepsia?
epigastric pain, burning sensation, early satiety, bloating, nausea, sickness, heartburn, discomfort
What is epigastric pain?
pain in upper abdomen under ribcage
What is organic vs functional disease?
- organic has cause that can be objective with tests, scans and imaging. GORD, ulcer, gastritis, cancer
- functional may be due to another systemic disease - cardiac or metabolic issues
How do we diagnose a patient with dyspepsia?
- history
- examination
- drug history
- lifestyle
- BMI
- Bloods full count, coeliac serology, ferritin, U&E, calcium, glucose
What are alarm symptoms in a patient displaying dyspepsia?
ALARMS
- anaemia
- loss of weight
- anorexia
- recent onset and >55
- melena and mass
- swallowing difficulty - dysphagia
When do you urgently refer a patient with dyspepsia to endoscopy?
- red flag symptoms or ALARMS
- include mass, vomiting>2wks, dysphagia and odynophagia, unexplained weight loss.
How common is dyspepsia?
very common - 80% of us have it but only 5% get referred and 1% have serious issue
What is an endoscopy? How do you prepare?
imaging to diagnose or for therapy of GI. use local anaesthetic of throat or sedate, and make sure fasted for a day. very low risk of bleeding or reaction to drugs.
What is the general steps for a patient presenting with dyspepsia?
- look for red flags - if present urgent referral
- if none give advice on lifestyle and PPI/H2RA
- do H-pylori test - if present treat and if not give 1 month PPI trial
- if h.pylori treatment ineffective do second line. if symptoms ongoing do breath urease test. if positive treat h.pylori again. if negative do PPI trial.
- If PPI trial ineffective check age. over 55 urgent refer. under 55 give PPi and H2RA. If responds well give back minimum dosage. if doesnt give routine referral
