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Peptic Ucler Disease

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Indications for Surgical Interventions Multiple ulcer site, drug induced ulcers, possible existence of malignant ulcer & obstruction.
Peptic Ulcer Disease It is a condition. It is the erosion of the GI mucosa as a result of contact with HCI and pepsin.
Ulcer development Any GI portion in contact with HCI. It can occur at the lower esophagus, stomach, duodenum.
Types: Acute: superficial and minimal. Chronic: muscular wall and forms a fibrous tissue.
Gastric Ulcers: These ulcers can be found lesser curvature. Women, older adults and lower economic status class are mostly like to get gastric ulcers. S & Sx: burning and gaseous.
Damaged mucosa Mucosa is damaged by increased smoking, drugs and alcohol; increased imcomptent pyloric sphincter and bile reflex; increased stress ulcers; H pyloric present, drugs (NSAIDS, ASA)
Duodenum Ulcers: Associated with High HCI. H. pyloric is present in most cases.
PUD: Complications: Hemorrhage Most common complication. It is developed from an erosion of the ulcer at the tissue base or erosion of the ulcer at the major blood vessel.
PUD: Complications: Perforation Most lethal complication. The ulcer penetrates the serosal surface. As a result, gastric contents spill into the peritoneal cavity.
PUD: Complications: Gastric Outlet Obstruction Increased contractile force to empty the stomach results in hypertrophy of stomach wall. Long standing of increased contraction results in dilation and atony.
PUD: DX Endoscopy; gastric analysis, Blood chemistry
Tests for H. pylori Serum blood, urea breath test, biopsy and rapid Urease test.
Care: Bed rest, bland diet, drug therapy, cessation smoking, stress reduction, and follow up.
Drugs: Histamine 2 Receptor Blockers Blocks the action of histamine, decreases HCI secretion, decreases the conversion of pepsinogin into pesin and increases ulcer healing.
Drugs: Proton Pump Inhibitors ATPase is needed for HCI secretion. PPI blocks ATPase.
Antacids Neutrializes acid.
Anti-biotic therapy These drugs eradicates H. pylori infection. 2 week triple therapy may be given.
Anticholinergic drugs Decreases the cholinergic stimulation of HCI secretion.
Cytoprotective drugs These drugs are used to for healing the ulcer.
Nutrition Therapy 6 meals per day; bland diet, no alcohol and milk.
Created by: libbygal_77
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