peptic ulcer disease Flashcards
where can PUD occur?
any aid affected site
- oesophagus
- stomach
- duodenum
what is the cause?
high acid secretion-duodenal
normal acid secretion-stomach
drugs-NSAIDS, steroids
why are peptic ulcers harmful?
burns tissues
can erode into an artery
how can PUD happen with normal acid secretion?
reduced protective barrier
- normally layer of mucus
- removed by drugs/bacteria
what bacteria survives in stomach?
helicobacter pylori-removes protective mucous, allowing ulceration
what are the effects of helicobacter pylori?
gastric ulcers
chronic gastric wall inflammation
-can lead to lymphoma of the stomach
-if tumour removed lymphoma & cause will dissapear
how are gastric ulcers eliminated?
triple therapy
-2 antibiotics
-1 proton pump inhibitor
can even work on lymphoma
what are PUD signs/symptoms?
none epigastric burning pain -worse before/after meals -worse at night -relieved by food, alkali & vomiting usually no physical signs
what are the PUD investigations?
endoscopy -oesophagus, stomach, duodenum radiology -barium meal anaemia -FBC, FOB's
what local complications can arise from PUD?
perforation -serious, can be fatal haemorrhage -erosion into bv, large vol blood in stomach, coffee ground vomit stricture malignancy
what systemic complication can arise from PUD?
anaemia
what medical tx?
stop smoking small regular meals eradication therapy ulcer healing drugs -eg proton pump inhibitor
what are surgical tx?
endoscope
surgical repair
-gastrectomy
vagotomy
what medication is used?
reduce acid secretion -H2 receptor blockers -proton pump inhibitors improve mucosal barrier -eliminate helicobacter -inhibit prostaglandin removal -avoid NSAID -reduce steroids
what drugs are used in triple therapy?
amoxycillin
metronidazole
omeprazole
