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
