Week 2 Pre-Learning: GI Tract - PUD, Gastritis Flashcards
Why does peptic ulcer disease occur?
- when ulcerative lesions are caused by exposure of the stomach or duodenal mucosa to HCL acid-pepsin secretions
How do peptic ulcers occur? (2)
- GI mucosa is normally protected by mucous containing HCO3- and mucin
- Ulcers develop when there is excess acid or diminished mucosal defense
What are the most common causes of PUD? (2)
- H. pylori infection
- NSAID use
Aggressive and defensive factors of PUD diagram
What percentage of people with PUD are infected with H. Pylori but do not develop ulcers?
up to 90%
What percentage of chronic NSAID users will develop pressure ulcers?
- 20%
What are the risk factors for PUD? (4)
- Diet - lack of protective foods (fibre, vitamin A)
- Smoking
- Alcohol
- Stress
What is the function of prostaglandins related to ulcers and gastritis? (3)
- Promotes secretion of bicarb and protective mucus
- Suppress secretion of gastric acid
- Maintains submucosal blood flow via vasodilation
Why does chronic NSAID use cause PUD? (4)
- NSAIDS suppress prostaglandins, increasing the risk for peptic ulcers and GI bleeding (GIB) by:
1. Decrease in that protective mucous production and decrease in neutralizing bicarb
2. Increased production of gastric acid
3. Decreased blood flow to the GI submucosa due to vasoconstriction
What are the symptoms of PUD? (2)
- can be asymptomatic
- pain is described as burning
What is a symptom for gastric ulcers?
- gaseous in epigastric area 1-2 hours after eating
What is a symptom for duodenal ulcers?
cramp-like in midepigastric or back pain, 2-4 hours after eating
What are three complications of PUD?
- Hemorrhage
- Perforation
- Gastric outlet obstruction
What is a hemorrhage caused by?
- due to erosion of granulation tissue at base of ulcer (more common in duodenal ulcer)
What are symptoms of a hemorrhage? (3)
- hematemesis
- Melena
- occult bleeding