Step II PUD Sx ..PPI or Scope first?

[NoWayOut]

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Sx suggestive of PUD..do you give a try with PPI first and see if there is a response? or do you go for endocopy and Bx with H.Pylori testing as your initial step in Mx?

 

[septoplasty]

1st....PPI

 

[NewYorkDoctors]

depends on presentation.

the rough idea for the test is:

If under 45YO w/o alarm factors (dysphagia, odynophagia, anemia, etc...) then try medical management first

If over 45 or w/ alarm factors, scope first

 

[NoWayOut]

Got it..thanks.

 

[ensuii]

depends on presentation.

the rough idea for the test is:

If under 45YO w/o alarm factors (dysphagia, odynophagia, anemia, etc...) then try medical management first

If over 45 or w/ alarm factors, scope first

Agree with above. If there are alarm factors highly suggestive of a gastric ulcer, you have to scope and biopsy to exclude malignancy.

 

[OveractiveBrain]

depends on presentation.

the rough idea for the test is:

If under 45YO w/o alarm factors (dysphagia, odynophagia, anemia, etc...) then try medical management first

If over 45 or w/ alarm factors, scope first

Dysphagia and Odynophagia ARE alarm symptoms, along with Weight Loss and Iron Deficiency Anemia

IF there are signs and symptoms of PUD (not gerd, but PUD) you go with the EGD and Bx

 

[themule]

Dysphagia and Odynophagia ARE alarm symptoms, along with Weight Loss and Iron Deficiency Anemia

IF there are signs and symptoms of PUD (not gerd, but PUD) you go with the EGD and Bx

He/She listed those as alarm symptoms.

"If under 45YO w/o alarm factors (such as dysphagia, odynophagia, anemia, etc...) then try medical management first"

The bolded text is obviously mine.

 

[OveractiveBrain]

He/She listed those as alarm symptoms.

"If under 45YO w/o alarm factors (such as dysphagia, odynophagia, anemia, etc...) then try medical management first"

The bolded text is obviously mine.

If there are signs and symptoms of PUD (PUD, not GERD) then you go to EGD first

your bolded text doesnt change my statement. If you have PUD, you go to EGD. If you have dyspepsia, you MIGHT try H.Pylori serology or PPI first. If you say s/s of PUD, you go to an EGD.

Be cute or get the answer right on the test.