Nurs 6550n Midterm GI section(Group study Guide) 2021 edition

• Evaluation, differential diagnosis, treatment options, and complications o Dyspepsia: acute, chronic, or recurrent pain in the upper abdomen ▪ Etiology: 1. Food or drug intolerance, functional with no obvious cause, luminal GI tract dysfunction, H-pylori infection, pancreatic disease, biliary tract disease or other conditions such as DM, thyroid disease, CKD, pregnancy or gastrointestinal ischemia. ▪ Symptoms: 1. Epigastric pain or burning, postprandial fullness, bloating, nausea or vomiting 2. If there is weight loss, persistent vomiting, severe pain or hematemesis then endoscopy warranted. ▪ Labs: 1. 50 years – CBC, BMP, LFT, calcium and thyroid function tests 2. 50 years with uncomplicated dyspepsia use noninvasive strategies 1st; H-pylori fecal test ▪ Upper Endoscopy: 1. Use for pts over the age of 50 who have new dyspepsia associated with weight loss, dysphagia, recurrent vomiting, bleeding or anemia. ▪ Other tests: 1. Patient with persistent symptoms or progressive weight loss, check for celiac disease, stool for parasites, or abdominal imaging such as CT or ultrasound ▪ Treatment: 1. Empiric • Proton pump inhibitor x 4 weeks, may have to use long term if symptomatic after stopping • If H-pylori positive, then antibiotic therapy warranted 2. Functional dyspepsia • Life style changes (limiting alcohol and caffeine intake), small low-fat meals • Pharmacologic • Oral PPI (omeprazole 20