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PEPTIC ULCER DISEASE,SLIDESHARE PRESENTATION

Peptic ulcer disease is characterized by open sores in the stomach or small intestine, resulting from an imbalance of protective and damaging factors, with duodenal ulcers being more common than gastric ones. Risk factors include smoking, alcohol, NSAID use, H. pylori infection, and stress, with varying symptoms such as abdominal pain and changes in appetite. Treatment involves lifestyle modifications, antibiotic therapy for H. pylori, and medications to reduce stomach acid, alongside surgical options for severe cases.

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Peptic Ulcer•
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Peptic ulcer disease 1
Definition 2 ❑Peptic ulcer are the open sores that occurs in the lining of the stomach or small intestine. It is the erosion of mucosal layer and break in the lining of the stomach . ❑Peptic ulcer results from imbalance of protective factors like bicarbonate ,mucus and damaging factors like acid and pepsin. ❑Incidence of duodenal ulcer is more common than gastric ulcer.
There are three types of peptic ulcers; ❑Gastric ulcers : ulcers that develop inside the stomach ❑Esophageal ulcers : ulcers that develop inside the esophagus ❑Duodenal ulcers : ulcers that develop in the upper section of the small intestines, called the duodenum 3
Risk factors: ❑Smoking ❑Alcohol intake ❑Spicy food ❑Prolong use of NSAIDS(eg; paracetamol, ibuprofen) ❑H.pylori ❑Stress like major injuries,illness,tumour. ❑Gender: duodenal ulcer are increasing in older women. ❑Age duodenal:30-40 ,,Gastric over 50
Difference between gastric and duodenal ulcer 5 Gastric. 1. They occur in stomatch. 2. They cause by injury like Substances,alcohol,aspirin,NSAIDs,drugs. 3. Pain in left epigastric region in gastric ulcer 4. Nausea is common, vomiting with blood occurs in this case. 5. Weight loss, pain starts just after taking food 6. Pain is present while hungry. 7.Malignancy is not common Duodenal 1. They occur in duodenum 2. these are cause by HCl secretion by vagus nerve 3. Pain in the right epigastric region 4. Stool with blood. 5. No weight loss,onset of pain after 2-4hrs of taking food 6. Absent 7. Malignancy is common
Etiology 6 ❑Epigastric pain ❑Nausea ❑Vomiting ❑Dyspepsia ❑Bloating ❑Belching ❑Pain after food intake ❑Radiation therapy ❑Stomach cancer
Clinical manifestations ❑The most common symptom of a peptic ulcer is burning abdominal pain that extends from the navel to the chest, which can range from mild to severe. In some cases, the pain may wake you up at night. Small peptic ulcers may not produce any symptoms in early phases. ❑Other common signs of a peptic ulcer include; ❑Changes in appetite ❑Nausea ❑Bloody or dark stools ❑Unexplained weight loss ❑Indigestion ❑Vomiting ❑Chest pain 7
Complications ❑Perforation leading to peritonitis ❑Haemorrhage by erosion of vessel in base. ❑Penetration of surrounding organ (liver/pancreas) ❑Obstruction (by scarring) - pyloric stenosis ( cancer – rare event in true peptic ulcer ) 8
Diagnostic tests 9 ❑Medical history ❑Physical exam ❑Lab tests • Stool examination for fecal occult blood • Complete blood count for decrease in blood cells. ❑Upper gastrointestinal endoscopy and biopsy ❑Upper GI series ❑Computerised tomography scan
Lifestylemodification ❑Discontinue NSAIDs ❑Smoking cessation ❑Alcohol cessation ❑Stress reduction 10
Drug management ❑Antibiotic medications to H. Pylori. If H.pylori is found in your digestive tract, the doctor may recommend a combination of antibiotics to kill the bacterium. These include amoxicillin,clarithromycin,methronidazole. ❑Proton pump inhibitors Also called PPIs reduce stomach acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over the counter medications like omeorazole,lansoprazole. ❑ Acid blockers Also called histamine blockers,reduce the amount of stomach acid released into your digestive tract, which relieves ulcer pain and encourages healing eg; ranitidine ❑Antacids Neutralize existing stomach acid and can provide rapid pain relief.side effects can include constipation or diarrhoea, depending on the main ingredients. 11
❑Vagotomy ❑Pyloroplasty ❑Subtotal gastrectomy 12 Surgical treatment
❑H. Pylori is the most common cause of PUD and is a risk factor for gastric cancer. ❑H.pylori eradication reduces the risk of the disease reoccurrence ❑Test and test strategy is recommended for patients with undifferentiated dyspepsia ❑Initial evaluation with endoscopy is recommended for those with alarm symptoms or those failing treating ❑Optimum treatment regimens are 14d multidrug with antibiotics and acid suppressants (triple therapy) 13 Summary
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