Gastric Uncer And Dyspepsia Flashcards
(21 cards)
What do goblet cells produce
Mucus to protect stomach lining
Parietal cells release
Gastric hydrochloride acid
Chief cells produce
Pepsinogen (protease enzyme precursor)
D cells produce
Somatostatin (inhibits acid production)
G ce;;s produce
Gastric (stimulates acid secretion)
What ways can you decrease gastric acid production
- proton pump inhibitors
- H2 receptor antagonists
- vagotomy
Dyspepsia meaning
Bad digestion
Dyspepsia with alarm symptoms
Weight loss
Dysphasia (diff swallowing)
Odynophagia
Persistent vomiting
Haematemesis
Melaena
Palpable spigastric mass
Gastric cancer family history
Onset over age of 45-55
Causes of dyspepsia
- gastro-oesophageal reflux disease - 13% - fingerlike inflammation projections up oesophagus
- peptic ulcer disease - 8%
- gastric cancer - 1%
- 80% with dyspepsia will have normal endoscopy - functional dyspeptic disease (1/6 of all patients)
Symptoms and signs of peptic ulcer
- epigastric pain after eating, may be relieved after ant acids, drinking milk
- epigastric tenderness
- nausea
- anorexia
- weightloss
Causes of peptic ulcer
- H pylori
- NSAIDS
- rarely zollinger Ellison syndrome + crohns
What percentage of ulcers caused by H Pylori
60% of gastric
80% of duodenal
What does the WHO class H Pylori as?
Carcinogen of gastric cancer family history
How much of dyspepsia is attributed to H Pylori
5%
What is used to get rid of H Pylori in infected individuals
- proton pump inhibitor
- combined 2 antibiotics
How does bacteria h pylori use urease
- converts ammonia to water
- cloud of ammonia and water
- cloud of ammonia neutralised acidic pH in stomach
- pylori can survive!!
Diagnosing H pylori - non invasive
Carbon urea breath test
Antibodies in H pylori serology (can also indicate past inf)
Stool antigen sample
Diagnosing H pylori - invasive
- done at time of endoscopy:
- rapid urease test
- biopsy/histological exams of biopsy specimens
What antibiotic are used for H pylori
- 2 antibiotics of:
- amoxicillin
- clarithromycin
- metronidazole
Complications of peptic ulcer disease and individual treatments
- perforation - surgery
- bleeding - endoscopy and heat treatment
- gastric outlet obstruction - pyloric stenosis (narrowing) - surgery
What are symptoms and signs of peptic ulcer bleeding
- haematemesis
- coffeground vomiting
- melaena
- rectal bleeding
- tachycardia
- hypotension
