Presentation on theme: "What is dyspepsia? A non-specific group of symptoms that relate to the upper GI tract: Epigastric pain Feelings of bloating or fullness Heartburn Rome."— Presentation transcript:
1What is dyspepsia?A non-specific group of symptoms that relate to the upper GI tract:Epigastric painFeelings of bloating or fullnessHeartburnRome II Definition:“Dyspepsia refers to pain or discomfort centred in the upper abdomen.”
2What can cause dyspepsia? Peptic ulcersGORDNon-ulcer dyspepsiaGastritis/duodenitisGastric malignancy!
3ALARM-Symptoms → Upper GI Endoscopy A L A R M S nemia oss of weight ALARMS or > 55→ Upper GI Endoscopyoss of weightnorexiaecent onset of progressive symptomsasses & Melaena/haematemesiswallowing difficulty
5Peptic Ulcers Gastric Ulcers Duodenal Ulcers - 4 times more common Pain after eating, often relieved by antacidsEpigastric pain relieved by eatingH. Pylori (80%), smoking, NSAIDs, stress, delayed emptyingH. Pylori (90%) & NSAIDs/aspirin/steroids
6Management Dyspepsia -ive +ive NICE Guidance > 55 orALARM Symptoms=EndoscopyDyspepsiaStop drugs eg NSAIDs Lifestyle changesOTC AntacidsReview after 4 weeks-ivePPI or H2-R antagonist treatment for 4 weeksIf no improvement:Test for H. Pylori+iveTreatment to eradicate H. PyloriReview after 4 weeks If no improvement:Repeat test if +ive re-treatIf -ive consider endoscopyNICE Guidancehttps://www.nice.org.uk/guidance/cg184
7Sensitivity Specificity 13C Breath TestThe 13C breath test is the most likely test to give a true result - it has the highest sensitivity & specificity.Note that histological sample is as effective however because this is an invasive test (endoscopic procedure) it is not used first-line.Why do we use the13C Breath Test?Sensitivity Specificity13C Breath Test % %Stool antigen % %Serology % %Histology % %