Flashcards in Dyspepsia + Peptic Ulcers Deck (12):
What is Dyspepsia?
Epigastric pain or burning.
What are the two categories of causes of Dyspepsia?
Organic - 25%
(e.g. Peptic ulcer disease, Drugs (NSAIDs, COX2 inhibitors), gastric cancer)
Functional - 75%
(e.g. idiopathic, associated with IBS etc.)
On examination what would you find in uncomplicated and in complicated Dyspepsia?
Uncomplicated - Tenderness only.
Complicated - Cachexia, mass, evidence of gastric outflow obstruction, peritonism
For treatment of Dyspepsia what are the Alarm features that would cause you to send the patient to a specialist?
Evidence of GI blood loss
Unexplained weight loss
Upper abdominal mass
What should you consider in uncomplicated dyspepsia?
If symptoms persist after lifestyle consideration and antacid use what is the next move?
H. pylori test.
If positive then eradicate
After H. pylori is negative or eradicated then consider the patients age, what would happen now?
>54 see a specialist
How would you diagnose an infection of H.pylori?
Urease breath test
Biopsy - histology, culture/sensitivity
Faecal antigen test
What is the treatment of Peptic ulcer Disease?
Test for H.pylori
- (if +ve - Eradicate and confirm)
- (if -ve - Antisecretory therapy)
For non-Hp/NSAID ulcers - Nutrition and optimise comorbidities
In the treatment of H.pylori infection what would be the commonest drugs used in week 1?
PPI + Amoxycillin + Clarithromycin
PPI + Metronidazole + Clarithromycin
What are the complications of peptic ulcer disease?
gastric outlet/duodenal obstruction - fibrotic scar