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Peptic Ulcer Disease

Peptic Ulcer Disease

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Page 1: Peptic Ulcer Disease

Peptic Ulcer Disease

Page 2: Peptic Ulcer Disease

Peptic Ulcer Disease

Page 3: Peptic Ulcer Disease

Peptic Ulcers Definition:

Ulcerated lesion in the mucosa of the stomach or duodenum

Types: Gastric Duodenal

Page 4: Peptic Ulcer Disease

Stomach Defense Systems Mucous layer

Coats and lines the stomach First line of defense

Bicarbonate Neutralizes acid

Prostaglandins Substances that keep blood vessels dilated

for good blood flow Stimulates mucus and bicarbonate

production

Page 5: Peptic Ulcer Disease

Risk Factors Lifestyle

Smoking Acidic drinks Medications

Helicobacterium Pylori infection

90% have this bacterium

Passed from person to person (fecal-oral route or oral-oral route)

Age Duodenal 30-50 Gastric over 60

Gender Duodenal: are

increasing in older men

Genetic factors More likely if a family

member has H.P.

Other factors stress can worsen it

but not the cause

Page 6: Peptic Ulcer Disease

Gastric Ulcers Pain occurs 1-2 hours after meals Pain usually does not wake-up the

patient Accentuated by ingestion of food Risk for malignancy Deep and penetrating and usually

occur on the lesser curvature of the stomach

Page 7: Peptic Ulcer Disease

Gastric and Duodenal Ulcers

Page 8: Peptic Ulcer Disease

Duodenal Ulcers Pain occurs 2-4 hours after meals Pain wakes up patient Pain relieved by food Very little risk for malignancy

Page 9: Peptic Ulcer Disease

General Peptic Ulcer Symptoms Epigastric tenderness

Gastric: epigastrium; left of midline Duodenal: mid to right of epigastrium

Sharp, burning pain Dyspepsia (indigestion) Nausea/vomiting

Page 10: Peptic Ulcer Disease

Complications of Peptic Ulcers Hemorrhage

Blood vessels damaged as ulcer erodes into the muscles of stomach or duodenal wall

Coffee ground vomitus or occult blood in tarry stools

Perforation An ulcer can erode through the entire wall Bacteria and partially digested fool spill into

peritoneum=peritonitis

Page 11: Peptic Ulcer Disease

Drug Therapy/Primary Goals Provide pain relief

Antacids and mucosa protectors Eradicate Helicobacterium pylori infection

Two antibiotics and one acid suppressor Heal ulcer

Eradicate infection Protect until ulcer heals

Prevent recurrence Decrease high acid stimulating foods in susceptible

people Avoid use of potential ulcer causing drugs Stop smoking

Page 12: Peptic Ulcer Disease

Surgery Required if ulcer is in one of these

stages:

Perforated and overflowed into the abdomen

Scarred or swelled so that there is obstruction

Acute bleeding Non-responsive to medications

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Types of Surgical Procedures Gastroenterostomy allows regurgitation of

alkaline duodenal contents into the stomach

creates a passage between the body of stomach to small intestines

keeps acid away from ulcerated area

Page 14: Peptic Ulcer Disease

Types of Surgical Procedures Vagotomy

Cuts vagus nerve Eliminates acid-

secretion stimulus

Page 15: Peptic Ulcer Disease

Surgical Procedure/Pyloroplasty

Pyloroplasty Widens the

pylorus to guarantee stomach emptying even without vagus nerve stimulation

Page 16: Peptic Ulcer Disease

BIBLIOGRAPHY “Peptic Ulcer Disease”. SlideShare.net< http://www.slideshare.net/kapradh/peptic-

ulcer-disease>