Gastro

Question 1

What are the classically differentiating symptoms between a duodenal and a gastric ulcer?

Answer 1

1. Gastric ulcer worse with food due to increased production of gastric acid
2. Duodenal ulcer better after food due to neutralisation of gastric acid by the food

Question 2

What is the aetiology of duodenal ulcers?

Answer 2

Virtually all by H.pylori
or NSAIDs

Question 3

How do you test for H.pylori?

Answer 3

Either
* Carbon urea breath test or
* Stool antigen

But breath test only one used to re-test after erradication

Question 4

What is the erradication regime for H.pylori?

Answer 4

7 days of Triple therapy with

• A PPI (e.g. omeprazole 20-40mg)
• Amoxicillin
• Clarythromycin or metronidazole (if penallergic, Clarithry + metronidazole, no amox)