Management of G.I. Disorders

G.I. DISEASES

• Peptic ulcer• Gastric cancer• Gastritis• Pancreatitis• Chronic benign gastric ulcer• Zollinger-ellison syndrome• Post gastrectomy syndrome

PEPTIC ULCER

What?

• Characterized by ulcerating mucosal lesions in upper G.I tract due to acid & pepsin attack

• Chronic inflammatory condition

Where?

• Stomach, duodenum

ETIOLOGY

• H.pylori infection• Hyperacidity• Drugs (NSAIDS & Corticosteroids)• Cigarette smoking• Alcohol• Stress• Rapid gastric emptying

SIGN & SYMPTOM

• Stomach ulcer• Anorexia• Heartburn• Epigastric pain• Nausea • Vomiting• Duodenal ulcer• Tenderness• Burning• Aching at belly button• Relieved by food intake & antacid

• HELICOBACTER PYLORI

•Most common infection in world (20%)

•10% men, 4% women

•Positive in 70-100% PUD patients

DIAGNOSIS

• Endoscopy• Barium meal (contrast x-

ray)• Biopsy (bacteria &

malignancy)• Culture (h.pylori)

COMPLICATIONS

Hemorrhage Due to ulcers eroding blood vessels

Penetration into adjacent structuresPancrease, biliary tract, liver colon

Perforation

DRUG THERAPY/TREATMENT

Provide pain relief(antacid + mucosal protector)

Eradicate H.Pylori infection(2 antibiotics + acid suppressor)

Surgery if,Perforated and overflowed in abdomenObstruction because of swellingNon responsive to medication

MANAGEMENT

• Avoid taking spicy, oily food intake• Stop smoking• Regular diet• Avoid NSAIDS

GASTRIC ULCER vs PEPTIC ULCER

• Clinical features1. Peptic Ulcer (most common)• Burning right epigastric pain 90 min to 3 hrs. after

meal• Often nocturnal• Relieved by food intake (as pyloric antrum closes,

preventing the gastric juice from passing to duo.)2. Gastric Ulcer• Burning left epigastric pain within 1 hr of food

intake• Anorexia, food aversion, • Weight loss in 40%• Unrelated to food

Jayesh Raut: 23Dhruvit Kalathiya: 22Shrutee Acharya: 21

Submitted to:

Dr. Sheetal madam

Presented by: