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Proton Pump InhibitorsAppropriate Use in General Practice
Life before PPIs The history of dyspepsia Surgery and dietVagotomy/Pyloroplasty Steamed fish and milk puddings H2-receptor antagonists Tagamet & SKF Zantac & Glaxo
Proton Pump InhibitorsLosec (Omeprazole)(Astra) Zoton (Lansoprazole)(Wyeth) Pariet (Rabeprazole)(Janssen) Nexium (Esomeprazole)(Astra)
NICE Guidance Issued in 2000Targeted use to make best use of resources
Dyspeptic Symptoms Diagnosed or not? Non-ulcer DyspepsiaPeptic Ulceration GORD
Peptic Ulceration Helicobacter-related? NSAID-related? ERADICATECo-Prescribe PPI if cannot stop NSAID
Gastro-Oesophageal RefluxSevere healing dose PPI until symptoms controlled maintenance dose to prevent recurrence Complicated stricture, ulcer, haemorrhage etc full dose maintained Mild alternative Rx: antacid, alginate, H2RA
Non-ulcer Dyspepsia Use Acid Suppressor (H2RA) NOT PPIStep-up or Step-down
Investigation Over 55 ENDOSCOPY Alarm Symptoms ENDOSCOPYdysphagia anaemia progressive weight loss Under 45 NO INVESTIGATION DEBATABLE
Gastroenterology in General Practice. Gastroenterology Dyspepsia Ulcer disease Non-ulcer dyspepsia Helicobacter pylori Altered Bowel Habit Constipation.
DYSPEPSIA Dr.Vishal Rathore. Dyspepsia popularly known as indigestion meaning hard or difficult digestion, is a medical condition characterized by chronic.
Clinical features of Upper GI origin More than 4 weeks duration Pain induced or worsened by food 40% of adults have in a life time Generally benign – promote.
Norman Evans Chief Pharmacist Wandsworth PCT South West London Finding The Resources – The Cost Challenge.
SIGNIFICANT EVENT MEETING – 2 PATIENTS WITH CANCER – 2 PATIENTS WITH CANCER Dr Stephen Newell 8/10/04.
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.
HELICOBACTER PYLORI Millions of years old microorganism of mankind Causes a spectrum of diseases Obviously requires high priority Treatment strategies.
GROUP D. narrowing of the esophagus(distal) near the junction with the stomach (squamocolumnar jxn). sequelae of gastroesophageal reflux– induced.
Drugs Used For Peptic Ulcer
DYSPEPSIA. Dyspepsia Implies chronic GORD IBS Ulcers Gall Stones Cancer ‘Functional’
DYSPEPSIA Leena Patel 1/2/12. OVERVIEW Statistics Red flags Management H-pylori testing and treatment.
Update of TARGET ( T reatment a nd R elief of G astroint e s t inal disorder) DR NORITA YASMIN MORNING READ 19/9/13 1.
Anti-Ulcer Agents Michael Alwan November 11, 2004
Drugs Used in Gastrointestinal System Prof. : Abdulqader A. ALHAIDER.
Antacids L. Scheffler 1.
Dyspepsia, Peptic Ulcer Disease and Helicobacter Pylori
GORD & Peptic ulcers Dr Alex Timperley FY2. Objectives Aetiology Signs & symptoms Investigations Management Complications Example cases.
Gastroesophageal Reflux Disease. “a prevalent and chronic condition in which reflux of the stomach contents into the oesophagus causes a range of troublesome.
Gastro Esophageal Reflux Disease Presented for Sherman Hospital By Lawrence R. Kosinski, MD, MBA, FACG March 24 th, 2004.
Cimetidine Anatomy Physiology Chemistry Pharmacology Neural effects
HEALING ULCERS Liquorice extract (licorice) for > 2000 years in China.... helps ulcers heal Prostaglandins are natural hormones that help heal holes in.
Peptic ulcer disease & GORD Students4Students Hugh Tulloch
Dyspepsia. one or more of the following symptoms Postprandial fullness, early satiation, epigastric pain, or burning.
Peptic Ulcer Disease Dr. Wael H. Mansy, MD Assistant Professor College of Pharmacy King Saud University.
BSG Guidelines Management of Dyspepsia
D YSPEPSIA & P EPTIC U LCER By Dr. Zahoor 1. D YSPEPSIA What is Dyspepsia ? Dyspepsia is used to describe number of upper abdominal symptoms such as.
PUD & GORD Nik Sanyal. Overview How common is it + what are the risk factors? What are the symptoms and signs? Investigations Management Possible exam.
Diagnostic Evaluation Radiographic barium study –Less sensitive in small ulcers <0.5cm –Well-demarcated crater (bulb) Endoscopic Procedure –Biopsy sample.
Pie Chart Showing the Breakdown of Gastro-intestinal Prescribing in General Practice in England (July June 2008 ) © Copyright NHSBSA 2008.
Gastroesophageal Reflux Disease (GERD) Any symptoms or esophageal mucosal damage that results from reflux of gastric acid into the esophagusAny symptoms.
DRUGS TO TREAT GASTRIC ACID SECRETION Helen Turnbull-Ross
Daguman, Emmanuel II Dadgardoust, Persia. Case 2 45 y/o male c/c: severe abdominal pain.
PEPTIC ULCER DISEASE DEFINITION: A disease characterized pathologically by ulceration of the mucosa of stomach, duodenum and some time of the lower oesophagus.
Determinants of gastro-oesophageal reflux perception in patients with persistent symptoms despite proton pump inhibitors F Zerbib, A Duriez, S Roman, M.
Pharmacology B Lin, I-Yao. A 43y/o male CEO of a multinational company experienced severe burning pain one and a half hour after a sumptuous lunch. This.
PEPTIC ULCER DISEASE Lykhatska G.V.. Peptic ulcer disease - Is recurrent disease, the main feature of which is the formation of defects (ulcers) of the.
Copyright (c) 2004 Elsevier Inc. All rights reserved. Drugs for Peptic Ulcer Disease Chapter 73.
Nursing Care of Patients WithUpper GI Disturbances
Topics Background Treatment Reading Assignments/Questions References
GERD and Peptic ulcer disease
ACID-PEPTIC DISEASE AND TREATMENT Introduction - A. Acid peptic includes: 1.Peptic ulcers (stomach and duodenal) 2.Gastroesophageal reflux disorders (GERD)
Dyspepsia Summary of the Today Session.
Agents Used to Treat Hyperacidity and Gastroesophageal Reflux Disease
Gastro Oesophageo Reflux Disease (GORD) JMJ1. Contents Pathophysiology Oesophageo mucosal defense mechanisms Clinical features Diagnosis and investigations.
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