Dyspepsia and Peptic Ulcer Disease Flashcards
(43 cards)
what is dyspepsia
indigestion
what are the symptoms in romes criteria of dyspepsia
epigastric pain/ burning, postprandial fullness, early satiety
where does the foregut start and end
cricopharyngeus to ampulla of vater
what structures are in the foregut
oesophagus, stomach, duodenum, pancreas, gallbladder
what is dyspepsia more common with
if H pylori infected, NSAID use, overlap with IBS/GORD
what are the causes of dyspepsia
organic causes;
peptic ulcer disease, drugs, gastric cancer
idiopathic causes (75%)
what is the difference between dyspepsia and heartburn/ relfuc
heartburn/ reflux is a burning sensation in the epigastric region
what is GORD
gastro- oesophageal reflux disease
what should be found on exam of uncomplicated dyspepsia
epigastric tenderness only
what might be found on examination of uncomplicated dyspepsia
cachexia, mass, evidence of gastric outflow obstruction (vomiting, splish and splash of gastric content around blockage), peritonism
how is dyspepsia treated
check H pylori status- eradicate if infected which will cure ulcer disease and remove risk of gastric cancer
if HP -ve treat with acid inhibItion
what lifestyle factors could cause dyspepsia
diet (spicy food, drink, infrequent meals)
what is functional dyspepsia
when there in no evidence of structural disease that explain the symptoms- idopathic
what can cause functional dyspepsia
visceral hypersensitivity, disrupted gut-immune interactions, abnormal upper GI motor and reflex functions, physiological factors, genetic factors, altered brain- gut interactions
what is peptic ulcer disease
a common cause of dyspepsia- pain predominant dyspepsia (which radiates to back) cause by gastric or duodenal ulcers
what is the onset/ aggravating factors of peptic ulcer disease
often nocturnal, relapsing and remitting chronic illness- aggravated/ relieved by eating
who is peptic ulcer disease more common in
lower socio-economic groups, people with FH of it
what are the causes of peptic ulcer disease
H pylori, NSAIDs (COX1, COX2, PGE),
gatric dysmobility and outflow obstruction thought to be associated
describe H pylori
gram -ve microaerophilic, flagellated bacillus
how is H pylori aquired
in infancy by oral-oral/ faecal oral spread
what gastric cancers area associated with peptic ulcer disease
almost all non-cardia gastric adenocarcinoma
low grade B-cell gastric lymphomas
is H pylori more common in develop/ developing world?
developing- possibly reflect sanitation
what effect does food have on the acidity of the stomach
food increases pH which stimulates G cells to release gastrin which stimulates parietal cells of the fundus to produce HCL
what happens when H pylori affects the distal stomach
If affects distal stomach G cells stimulated which lead to over stimulation of parietal cells which creates hyper acidic state which creates gastric metaplasia.
Duodenal mucosa cant be infected with h pylori but the gastric metaplasia can cause duodenal ulcer. Will move proximally causing an increased amount of gastrin but acid making ability defect so excessive amount of gastrin= alkaline stomach+ hypertrophy= risk of gastric cancer
