Dyspepsia

Question 1

Red flag symptoms for Dyspepsia?

Answer 1

haemetemesis
>45 1st presentation
>55 and persistent unexplained symptoms
mass/swelling
persistent vomiting
anaemia symptoms
progressive weight loss
chest pains

Question 2

Management if presenting with any red flag symptoms associated with dyspepsia?

Answer 2

2-week endoscopy referral

Question 3

Difference between treatment of uninvestigated dyspepsia and functional dyspepsia?

Answer 3

Both test for H.pylori but….
- Full-dose PPI for uninvestigated dyspepsia 4/52

• Low-dose PPI for functional dyspepsia 4/52

Question 4

When should alginates/antacids be used in dyspepsia?

Answer 4

Only for short-term use for symptom relief

Question 5

What conditions may dyspepsia lead to a diagnosis of?

Answer 5

Functional dyspepsia, GORD and heartburn, gastritis, gastric and duodenal ulcers.

Question 6

Define full-dose PPI

Answer 6

E.g., Omeprazole 20mg OD, Lansoprazole 30mg OD

Question 7

Define low-dose PPI

Answer 7

E.g., Lansoprazole 15mg OD/PRN
Omeprazole 10mg OD/PRN

Question 8

How long before an endoscopy should a PPI/ H2 receptor antagonist be stopped?

Answer 8

2 weeks before

Question 9

MHRA alert associated with PPIs

Answer 9

SCLE (subacute cutaneous lupus erythematosus) can occur days, months, or years after exposure to PPIs

Question 10

Side effects of PPIs

Answer 10

GI disturbances, insomnia, osteoporosis, poor absorption of vitamin B12, hypomagneasia, hyponatremia, headache

Question 11

Why should PPIs AND H2 antagonists not be prescribed in someone with alarm symptoms before endoscopy?

Answer 11

They can mask the signs of malignancy

Question 12

Symptoms of SCLE to look out for after a PPI has been prescribed

Answer 12

Arthralgia and skin lesions where skin has been exposed to the sun

Question 13

Side effects of H2 receptor antagonists

Answer 13

GI disturbances, myalgia, headache, fatigue, skin reactions