Dyspepsia

Question 1

management of
dyspepsia with chronic GI bleeding or >55 and weight loss

Answer 1

urgent referral to specialist

Question 2

management of representation of dyspepsia after previous diagnosis

Answer 2

Treat on basis that similar pathology has recurred
If patient unresponsive to treatment or diagnosis unclear refer to specialist

Question 3

what medications can cause dyspepsia

Answer 3

NSAIDs, steroids, calcium antagonists, nitrates, theophylines and bisphosphonates

Question 4

management of first presentation of dyspepsia

Answer 4

review medications
lifestyle advice
recommend antacids
test for h.pylori
try PPI for one month

Question 5

where are PPIs metabolised

Answer 5

liver mostly

Question 6

how should long term use of PPIs be managed and why

Answer 6

weigh up risks and benefits as increase risk of gastric cancer

Question 7

monitoring of treatment

Answer 7

check for h.pylori eradication
check after month or two of PPI that they are working and there is no warning signs of malignancy (e.g. weight loss)