Peptic Ulcer Flashcards
What is peptic ulcer
It is an ulcer in the lower oesophaugs, stomach, or duodenum
basically, epithelium is damage then basement membrane damage causes bleeding, GI bleed.
When can an ulcer present in the Jejunum
after gastrojejunostomy
What is the Ph in the upper stomach
4.0-6.5
What is the Ph in the lower stomach
1.5-4.0
What is the Ph in the duodenum
7.0-8.5
What is the Ph in the small and large intestines
4.0-7.0
Describe the path of the GI tract
Mouth
Oesophagus
Stomach
Duoedenum
Jejunum
Illeum
Ilioceacal junction
Caecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Symptoms of duodenal ulcer
X4 commoner than Gastric ulcer
Epigastric pain relevied by eating or drinking milk.
Typically the pain starts before meals or at night.
50% are asymptomatic
Tender epigastrium
A 55 year old presents with epigastric pain worse at night and relieved by eating or drinking milk.
Which investigation you would like to do?
Endoscopy
Symptoms of gastric ulcer
Usually occur in elderly
Asymptomatic or epigastric pain that is worse with meals but relieved by antacids.
Risk factors of peptic ulcers
H pylori
Smoking
NSAIDs
reflux of duodenal contents
increased gastric secretion
How to diagnose H.pylori infection
carbon-13 urea breath test
Feacal antigen test
Antral biopsy
rapid urease test
microbiological culture
How to treat peptic ulcers
Conventional: Avoid triggers
H. pylori triple therapy - 1 PPI and 2 Abx
PPI helps rerduce acidity
Stop causative drugs - NSAIDs
What complications might occur with peptic ulcer disease
Bleeding
Perforation
Malignancy
Gastric outflow obstruction
Where is perforation more common
In duodenal ulcers
