peptic ulcers, gastric ulcers, stomach ulcers

how do you treat H. pylori infection?

antibiotics proton pump inhibitors

duodenal ulcers pathology

associated with high HCl acid secretion acid and pepsin concentrations in the duodenum penetrate the mucosal barrier and cause ulceration

major causes of duodenal ulcers

HYPERSECRETION OF HCL ACID acid from cigarette smoking ingestion of ETOH NSAIDs inadequate secretion of bicarb by duodenal mucosa H. PYLORI toxins and enzymes that promote inflammation and ulceration

peptic ulcer disease

condition characterized by erosion of the GI mucosa resulting from digestive action of HCl and pepsin

deep peptic ulcer

true ulcers extended through the muscular is mucosae and damage blood vessels causing hemorrhage or perforate GI wall

chronic ulcer

eroding through the muscle wall formation of fibrotic tissue long duration (months) intermittently throughout lifetime

superficial peptic ulcer

erosions erode the mucosa but do not penetrate muscularis mucosae

ulcer complications

hemmorhage perforation- most lethal gastric outlet obstruction- must vomit

gastric ulcer risks

medications H. Pylori smoking bile reflux

chronic peptic ulcer

scarring present

gastric ulcers

tend to develop in the antrum of the stomach, adjacent to the acid- secreting mucosa of the body more common in women and older adults develop older >50 more likely to result in obstruction

acute ulcer

superficial erosion minimal inflammation short duration

ulcer diagnosis

x-ray endoscopy evaluation and biopsy radioimmune assay of gastric levels H. pylori testing CBC (anemia from bleeding) urea is byproduct of metabolism of H. pylori bacteria and identifies an active infection

duodenal ulcers

80% of all ulcers develops on younger persons 35-45 individuals with type O blood more susceptible to H. pylori

gastric ulcer clinical manifestations

pain described as burning or gaseous pain of gastric ulcer also may occur immediately after eating within 1-2 hours gastric ulcers cause more anorexia, vomiting, weight loss than duodenal ulcers

clinical manifestations of duodenal ulcers

pain, burning, cramping in mid epigastric region (beneath xiphiod process) pain occuring in the night that disappears by morning pain when stomach is emptying, eating relieves pain hemmorhage or perfiration pain when gastric acid contacts the ulcer

peptic ulcer disease risk factors

smoking H. pylori alcohol coffee advanced age Medications and NSAIDS (aspirin&corticosteriods) chronic disease