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PEPTIC ULCER
DISEASE(revised)
RN
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Peptic Ulcer DiseaseULCER craterlike lesion in a membrane
Ulcers tat develop in areas o! te "IT e#posed to acidic$astric %&ice are called PEPTIC ULCERS
Erosions vs Tr&e Ulcers
PUD ' can develop in te loer esopa$&s stomacd&oden&m or %e%&n&m
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T*+ ,A-+R .+R,SD&odenal Ulcer a/ect te &pper part o! te small intestines
acco&nts 012 o! PUD
"astric Ulcer
a/ects stomac linin$ common in middle'a$ed 3 elderl4esp5 poor 3
malno&rised
common in cronic &sers o! ASA 3 R+6
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Etiolo$4 7 U898+*8
,A-+R C+8TRI:UT+RS
Camp4lobacter p4lori
Ureasesplits te &rea into ammonia andC+;
Catalase
Adesion proteins
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,A-+R C+8TRI:UT+RS
8on'steroidal anti'in&ac4 ma4 alsocontrib&te
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Contrib&tin$ !actors
Personal type A & Blood Type O
Genetic predisposition
Tobacco use
Ingestion of food or drugs
tress
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PATHOPHYSIOLOGY
ULCERATION
^ HCl ACID
PRODUCTION
:ILE SALTS ASPIRI8 ALC+6+LISC6E,IA
DA,A"ED ,UC+SAL :ARRIER
DEC5 .?8 +. ,UC+SAL CELLSDEC5 @UALIT +. ,UCUS
L+SS +. TI"6T -U8CTI+8S :ET5 CELLS
PEPSINOGEN
PEPSIN
FORMATION AND
LIBERATION OF
HISTAMINE
:AC9'DI..USI+8 +. ACID I8T+ "ASTRIC,UC+SA
FURTHER MUCOSALEROSION
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ULCERATION OF MUCOSA
(GASTRIC / DUODENAL)
!burning, gna"ing, orcrampli#e pain!epigastrictenderness
!$oluntary muscleguarding
NO TXMENT?
CONTINUOUS EROSION OF
MUCOSA
A B C
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Erosion o !"#
$l%#r in!o &n&r!#r' or #in
P#ror&!ion o !"#
$%os&l *&ll
G&s!roin!#s!in&l
+l##,in-
s/sx:
hemate
mesis
melena
anemia
S.ill&-# G&s!ri%
#n'#s &n, +ol$s
in!o &+,oin&l %&i!'
A B
S%&rrin- &n, s*#llin- o
!"# $%os&
N&rro*in- in !"#
,$o,#n$ &n,/or
n#&r .'lori% %&n&l
C
P#ri!oni!is &n, .&n%r#&!i!is
M&ssi# +loo,
loss
s"o%0
S#.sis
S#.!i% s"o%0
DEATH
G&s!ri% o$!l#!o+s!r$%!ion
Dis!#n!ion &n, !iss$#
,&&-#
B
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http://images.search.yahoo.com/search/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dhelicobacter%2Bpylori%26ei%3DUTF-8%26fr%3Dyfp-t-331%26fp_ip%3DPH%26x%3Dwrt%26js%3D1%26ni%3D20&w=300&h=225&imgurl=www.gastroenterologe.de%2F_gfx%2Fhel_pylori.jpg&rurl=http%3A%2F%2Fwww.gastroenterologe.de%2Fpatient%2Ferkrankungen%2Fmagen%2Fhelicobacter_inf.html&size=4.7kB&name=hel_pylori.jpg&p=helicobacter+pylori&type=jpeg&no=13&tt=8,141&oid=c1f0749f6ff76924&ei=UTF-8http://images.search.yahoo.com/search/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dhelicobacter%2Bpylori%26ei%3DUTF-8%26fr%3Dyfp-t-331%26fp_ip%3DPH%26x%3Dwrt%26js%3D1%26ni%3D20&w=148&h=214&imgurl=water.usgs.gov%2Fnrp%2Fproj.bib%2Fmicrobiology%2FHelicobacter_pylori.jpg&rurl=http%3A%2F%2Fwater.usgs.gov%2Fnrp%2Fproj.bib%2Fmicrobiology%2Fyukonriver_ak.html&size=6.9kB&name=Helicobacter_pylori.jpg&p=helicobacter+pylori&type=jpeg&no=2&tt=8,141&oid=395019b0d8c7a1a2&ei=UTF-87/25/2019 Peptic Ulcer Dse Pathophysiology
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%AT TO 'OO( )OR *
"ASTRIC ULCER
recent loss of "eight
heartburn, indigestion, sharp
abdominal fullness
DU+DE8AL ULCER
burning pain
recent "eight gain
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Di&-nos!i% T#s!s
B&ri$ S*&llo* / UGIS / S&ll Bo*#l
S#ri#sGI En,os%o.' /
Eso."&-o-&s!ro,$o,#nos%o.'
1 Bio.s' &n, "is!olo-' *i!" %$l!$r#S!ool #2& &n, o%%$l! +loo,3BC Co$n!
G&s!ri% s#%r#!or' s!$,i#sC&r+on456 Ur#& Br#&!" T#s!
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M&n&-##n!
%o+in&!ion o &n!i+io!i%s7 .ro!on .$. in"i+i!ors7
"is!&in# (H8) r#%#.!or &n!&-onis!
&n!&%i,s
-&s!ri% &s.ir&!ion
s!r#ss r#,$%!ion &n, r#s!
so0in- %#ss&!ion
,i#!&r' o,ii%&!ion
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+RGIA' -GT
Total Gastrectomy . /sophago0e0unostomy
1agotomy 2 surgical di$ision of the $agal ner$e
Gastric resection . antrectomy
Billroth I . Billroth II
Pyloroplasty
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3umping yndrome
rapid emptying of the gastric contents into the smallintestine
S4mptoms4 usually occur 56 mins pc
abdominal cramping
diarrhea
palpitations
tachycardia
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