Upper GI

Question 1

what’s the structure of the GI tract

Answer 1

liver bile salts –> gall bladder stores bile salts –> stomach –> small intestine –> large intestine

Question 2

what motion is the material in the GI moved by

Answer 2

peristalsis

Question 3

whats dyspepsia

Answer 3

upper abdominal pain
heartburn
nausea
vomiting

for 4 or more weeks

Question 4

whats the common causes of dyspepsia

Answer 4

Gastro-oesophageal Reflux Disease

peptic ulcers - gastric/ duodenal ulcers

functional dyspepsia (non-ulcer dyspepsia)

Question 5

what are the symptoms of dyspepsia

Answer 5

abdominal discomfort
bloating
flatulence
feeling of fullness
heartburn
nausea and vomiting

Question 6

what are risk factors associated with dyspepsia

Answer 6

smoking

pregnancy → damage to sphincter

obesity

stress anxiety dep

NSAIDS

caffeine, spicy foods and alcohol

Question 7

what’s GORD

Answer 7

sphincter weakened → causes stomach acid to reflux into oesophagus

causes pain in the heart region

Question 8

what’s Gastritis

Answer 8

inflammation of the stomach lining caused by excess acid production

caused by Helicobacter Pylori bacteria
not treated → stomach contents leak into body
blood in stool

Question 9

whose at risk of Gastritis

Answer 9

NSAIDS ppl
alcohol

Question 10

what are duodenal and gastric ulcers

Answer 10

open sores in stomach or duodenum

caused if gastritis isn’t treated properly

Question 11

what Q to ask someone whose suffering from dyspepsia ? (10)

Answer 11

how old are they?

Pain location?

How long pain lasted?

other symptoms?

Had before? what helped?

OTC ?Herbal? Prescription?

lifestyle- what they eating when pain? drink? smoke? exercise?

Anything that aggravates or alleviates the pain?

Preggers? Breastfeeding?

Does pain radiate?

Question 12

what are dyspepsia red flags (10)

Answer 12

never had B4 > 50 → Doc

Child → Doc

Pain radiates elsewhere Heart attack → A&E

Debilitating symptoms (affect life a lot) → Doc

Persistent vomiting/ blood in vomit → A&E

Blood in stool/ black and tarry → A&E

change in bowel habits

food stuck in throat → cancer → Doc

unexplained weight loss

Treatment fails to manage symptoms

Question 13

what the treatment for dyspepsia? what are the different combinations available

Answer 13

Antacids bc they neutralise stomach acid

sodium + potassium - rapid onset BUT short duration of action

magnesium + Aluminium - dissolve slower BUT last longer

Calcium - fast acting long duration

Question 14

what do manufacturers often do when making antacids

Answer 14

mix the combinations together for fast onset and long duration

e.g sodium bicarbonate + magnesium alginate

Question 15

what’s a medicine to help dyspepsia? how does it work?

Answer 15

Gaviscon

HOW
sodium alginate → low density gel , stops acid going up oesophagus

calcium carbonate → reduces pH of stomach acid, Ca2+ strengthens alginate gel

Sodium bicarbonate → CO2 gas, stops acid going up oesophagus

Question 16

when do you take Gaviscon?

Answer 16

after food B4 bed

diff forms available, liquid works best but may be less convenient

liquid Gaviscon safe in pregnancy

Question 17

what are Proton Pump Inhibitors

Answer 17

reduce gastric acid secretion

bind irreversibly to hydrogen potassium pump so cant secrete acid

Question 18

what are some OTC Proton Pump Inhibitors

Answer 18

esomeprazole + Omeprazole

only licensed for 18+ yr old
only 14 days
check CI’s
slow acting 1-2 days

Question 19

what’s some lifestyle advice for dyspepsia

Answer 19

eat little but often

avoid trigger food e.g spicy, caffeine etc

smoking cessation

weightloss for overweight patients

nocturnal reflux → raise head of bed ad pillow

Question 20

what are stomach ulcers

Answer 20

breach in epithelium of gastric/ duodenum mucosa

confirmed by endoscopy

Question 21

what are risk factors associated with stomach ulcers

Answer 21

Helicobacter pylori infection

use of NSAIDS or aspirin

Question 22

what are some complications associated with stomach ulcers

Answer 22

can cause sepsis

internal bleeding

REFER STRAIGHT TO HOSPITAL

Question 23

what are the signs and symptoms of stomach ulcers

Answer 23

abdominal pain bloating

pain described as burning between meals and night

nausea, vomiting

blood in vomit/ looks like coffee granules

blood in stool/ tarry/ black/ sticky

fatigue

indigestion

Question 24

whats nausea

Answer 24

discomfort in stomach

unease, queasiness, urge to vomit

Question 25

whats some lifestyle advice for stomach ulcers

Answer 25

lose weight if overweight avoid trigger foods : caffeine, choco, spicy smaller meals eat meal 2-3 hrs B4 bed smoking cessation reduce alcohol consumption stress, depression encourage relaxation techniques ensure NSAID'S taken with food

Question 26

vomiting

Answer 26

forceful compulsion of gastric contents ↑sed activity in vomiting centre in medula oblongata → detected by CTZ → send signal to GI tract

Question 27

what are some causes of vomiting

Answer 27

GI issues → indigestion, food poisoning, stomach infection, motion sickness morning sickness 1st trimester vertigo/ labyrinthitis stress, anxiety migraine sinister pathology - appendicitis/ brain injury

Question 28

what's some lifestyle advice for nausea and vomiting

Answer 28

plenty of fresh air distract yourself - film, hobbie, music sips of cold water anything containing ginger -biscuit, ale, tea peppermint tea smaller more frequent meals

Question 29

what NOT to do when nausea vomiting

Answer 29

DON'T eat/ cook foods with strong smells eat hot, fried, greasy foods eat too quickly drink lots of water with meal lie down after meal wear tight things around waist/ stomach

Question 30

vomiting and nausea during pregnancy

Answer 30

begins around 4-7th week peaks around 9-16 weeks stop 16-20 weeks after 11 weeks → not pregnancy related

Question 31

what are some risk factors associated with vomiting in pregnancy

Answer 31

multiple pregnancy twin first time preggers if mum/auntie had bad sickness obese

Question 32

what's some lifestyle advice for pregnant women

Answer 32

Rest as needed; avoid triggers such as strong odours, heat, and noise Eat plain biscuits or crackers in the morning Have small, frequent, bland meals that are protein-rich and low in fat and carbohydrates Choose cold meals if smells trigger nausea Drink small amounts frequently rather than large volumes Use ginger (fresh, tea, capsule, or syrup) Try acupressure at the P6 wrist point (wrist band or finger pressure) (proper professional)

Question 33

what are some red flags for nausea and vomiting

Answer 33

early morning vomiting in child bearing aged women vomiting in child <1 yr for more than 24hrs moderate/ severe abdominal pain - appendicitis ? unexplained nausea and vomiting vomiting blood A&E loss in body weight especially preggers women