Dyspepsia

Question 1

dyspepsia - This is a constellation of symptoms, what are they? 3

Answer 1

• epigastric pain or burning (epigastric pain syndrome)
• postprandial fullness (postprandial distress syndrome)
• early satiety (postprandial distress syndrome)

Question 2

dyspepsia may have overlap with ___ /____

Answer 2

IBD/GORD

Question 3

what increases the incidence of dyspepsia? 2

Answer 3

if H.pylori infected

if NSAID use

Question 4

causes of dyspepsia can either be ___ (25%) or ____ (75%)

Answer 4

organic or functional

Question 5

what are the organic causes of dyspepsia? 3

Answer 5

1. peptic ulcer disease
2. drugs
3. gastric cancer

Question 6

which drugs especially are linked with organic dyspepsia?

Answer 6

NSAIDS, COX2 inhibitors

Question 7

what is functional dyspepsia?

Answer 7

No evidence of structural disease but have the characteristic constellation of symptoms

Question 8

functional dyspepsia is associated with what?

Answer 8

Associated with other functional gut disorders e.g. IBS

Question 9

what is an example of another functional gut disorder?

Answer 9

IBS

Question 10

what is the differential diagnosis of dyspepsia? 6

Answer 10

• non-ulcer dyspepsia
• oesophagitis /GORD
• DU/GU
• gastric malignancy
• duodenitis
• gastritis

Question 11

what are the ALARM Symptoms? 6

Answer 11

• Anaemia (iron deficiency
• Loss of weight
• Anorexia
• Recent onset/progressive symptoms
• Meleana /haematemesis
• Swallowing difficulty

Question 12

if the dyspepsia is uncomplicated, what would the physical examination show?

Answer 12

epigastric tenderness only

Question 13

if the dyspepsia is complicated, what would the physical examination show?

Answer 13

• cachexia
• mass
• evidence of gastric outflow obstruction
• peritonism

Question 14

what are signs of gastric outflow obstruction? 2

Answer 14

abdominal distension

succussion splash

Question 15

what are the treatment and diagnosis options?

Answer 15

• stool antigen test to check HP status
• eradicate if infected
• if HP negative , treat with acid inhibition as required

Question 16

what does the eradication of HP do? 2

Answer 16

cures ulcer disease and removes risk of gastric cancer

Question 17

if the patients are over 55 or have ALARM symptoms, what should be done?

Answer 17

endoscopy

Question 18

if the patient is under 55 or does not have ALARM Symptoms , what should be done? 4

Answer 18

• stop drugs causing dyspepsia
• lifestyle changes
• antacids
• review after 4 weeks and if no improvement test for H.P