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301 > Dyspepsia, GORD & GI Ulcers > Flashcards

Dyspepsia, GORD & GI Ulcers Flashcards

1
Q

Define GOR

A

Gastric-oesophageal reflux:
When the acidic contents of the stomach flows back into the oesophagus

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2
Q

Define GORD

A

When symptoms of GOR affects one’s wellbeing

Symptoms occur 2+ /week

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3
Q

Define Dyspepsia

A

Group of symptoms affecting upper abdomen:
- heartburn
- upper abdominal pain
- bloating

No obvious cause eg. Ulcer

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4
Q

Oesophagus?

A
  • muscular tube
  • collapsed when not involved in transporting food to stomach
  • thickening of circular smooth muscle - where oesophagus joins the stomach
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5
Q

Lower Oesophageal Sphincter

A
  • valve - keeping stomach contents out of the oesophagus
  • relaxes - during swallowing, allowing food to pass
  • constricts - preventing acidic contents of stomach into oesophagus
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6
Q

Why might the presence of the acidic stomach content in the oesophagus be an issue?

A
  • the acid can break down tissue in the oesophagus which can cause inflammation and ulcers
  • the stomach has a mucosal lining which protects it from HCI, but the oesophagus does not
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7
Q

Pathophysiology of GORD

A

Reflux occurs when there is a loss of LOS tone
- Relaxation of the sphincter naturally occurs when the stomach expands, Allowing small amounts of acid into the oesophagus after meals

= Transient Lower Esophageal Sphincter Relaxations

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8
Q

When are gastric contents more likely to reflux?

A
  • after meals
  • gastric volume is increased
  • gastric pressure is increased
  • gastric contents are near junction
  • obesity, pregnancy, tight clothes 
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9
Q

Causes of GORD?

A
  • genetics (higher risk if immediate family is sufferer
  • age (increased incidence with increase age)
  • gender
  • pregnancy
  • fatty and spicy foods, mint, caffeine
  • obesity
  • stress
  • smoking
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10
Q

Which medication are linked with GORD?

A
  • antibiotics
  • anticholinergics
  • antidepressants
  • iron/potassium supplements
  • NSAIDs
  • BZDs
  • progesterone
  • calcium channel blockers
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11
Q

What is Hiatus hernia?

A

An abnormally where the top part of the stomach squeezes into the chest, through diaphragm through the diaphragm hiatus

Increase amount of gastric juice enters oesophagus

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12
Q

Symptoms of Hiatus Hernia

A
  • heartburn
  • waterbrash
  • regurgitation
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13
Q

Complications of Hiatus Hernia?

A

Reflux oesophagitis
- non-erosive - mucous is normal or red in colour
- erosive - mucosal damage and ulcer

Stricture

Barrett’s oesophagus

Adenocarcinoma (cancer of mucous producing cells)

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14
Q

Hiatus in Babies?

A
  • doesn’t usually require investigation
  • medical treatment if: gagging, chocking, pneumonia
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15
Q

Causes of Dyspepsia?

A
  • reflux
  • PUD
  • H.pylori
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16
Q

What are Dyspepsias reg flags

A
  • > 55
  • abdominal bloating/pain
  • GI bleeding
  • difficulty swallowing
  • weight loss

^ refer to GP

17
Q

Non-pharmacological treatment for GORD/Dyspepsia?

A
  • healthy eating
  • smoking cessations
  • avoid eating large meals before bed
  • raise bedhead at night
18
Q

Which class of medications are used in dyspepsia/GORD?

A
  • Antacids
  • H2 Antagonist
  • PPI
19
Q

Antacids MOA

A

Neutralises HCI, which is secreted by parietal cells

20
Q

Examples of Antacids?

A
  • magnesium salts
  • aluminium hydroxide
  • sodium carbonate
21
Q

Antacids Interactions?

A
  • phenytoin - decreases absorption of phenytoin, causing loss of seizure control
  • quinolone - decreases absorption causing loss of antibiotic efficacy
22
Q

Antacid with Simethicone?

A

Antifoaming agents - relieves flatulence

23
Q

Antacids with alginates

A

Rafting agent - help viscosity of stomach content, protecting oesophagus from acid content

24
Q

H2 Antagonist MOA?

A

Competitively blocks H2 receptors, reducing acid secretion

25
Q

Examples of H2 Antagonists?

A
  • cimetidine
  • famotidine
  • nizatidine
  • ranitidine
26
Q

Non-endoscopic diagnosis for H.pylori

A
  • serology
  • urea breath test
  • fecal antigen test
27
Q

Endoscopic diagnosis for H.plyroi

A
  • rapid urea test
  • histology
  • culture

301 (27 decks)

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