Peptic Ulcer Disease

Question 1

what is peptic ulcer disease?

Answer 1

ANY acid affected site

Question 2

where can peptic ulcer disease occur?

Answer 2

• oesophagus
• stomach
• duodenum

Question 3

what are the causes of peptic ulcer disease?

Answer 3

• too much acid secreted

- acid secreted into the wrong place

Question 4

what drugs can cause peptic ulcer disease?

Answer 4

• NSAIDs

- steroids

Question 5

what causes a gastric ulcer?

Answer 5

gastric inflammation

Question 6

what complications can arise from gastric or duodenal ulcers?

Answer 6

• bleeding ulcer

- perforated ulcer

Question 7

where would you find a gastric ulcer?

Answer 7

in the stomach

Question 8

what is occurring when peptic ulcer disease occurs from a normal acid secretion?

Answer 8

involvement of bacteria which causes a reduced protective barrier

Question 9

what bacteria is involved in peptic ulcer disease?

Answer 9

Helicobacter pylori

Question 10

what does infection with bacteria eventually cause?

Answer 10

causes loss of the protective mucous barrier

Question 11

how does the bacteria affect the gastric mucosa?

Answer 11

causes inflammation of the gastric mucosa (gastritis)

Question 12

what can occur from chronic gastric wall inflammation due to bacteria?

Answer 12

lymphoma of the stomach (mucosa associated lymphoid tumour)

Question 13

how can peptic ulcer disease causing bacteria be eliminated??

Answer 13

WITH TRIPLE THERAPY

• 2 antibiotics
• 1 proton pump inhibitor

Question 14

what are the signs and symptoms of PUD?

Answer 14

• often asymptomatic
• epigastric burning pain
• usually no physical signs

Question 15

explain the epigastric pain felt by patients experiencing PUD?

Answer 15

• worse before/just after meals
• worse at night
• often relieved by food, alkali & vomiting

Question 16

how is PUD investigated?

Answer 16

• endoscopy (preferred)
• radiology
• test for anaemia (FOBs)

Question 17

what are the complications of PUD?

Answer 17

• perforation
• haemorrhage
• stricture
• malignancy
• anaemia

Question 18

what is meant by perforation caused by PUD?

Answer 18

the acid burns a hole in the wall of the stomach/duodenum

Question 19

what happens if a haemorrhage occurs due to PUD?

Answer 19

erosion of the ulcer into a blood vessel, causing heavy bleeding

Question 20

what happens when stricture occurs?

Answer 20

• scarring makes the space (stomach/duodenum) smaller

Question 21

why might anaemia occur in PUD patients?

Answer 21

due to bleeding caused by the ulcer

Question 22

what are some MEDICAL treatments for PUD?

Answer 22

• stop smoking
• small regular meals
• ulcer healing drugs
• eradication therapy

Question 23

when is it appropriate to go down the MEDICAL route for PUD?

Answer 23

when the PUD is:

• a reversible problem
• can be fixed by making lifestyle changes
• due to presence of H. pylori

Question 24

when is SURGICAL treatment necessary in PUD patients?

Answer 24

when PUD has caused:

• stricture
• acute bleed
• perforation
• malignancy

Question 25

what surgical procedures can be used in PUD?

Answer 25

• endoscopy
• gastrectomy
• vagotomy
• repair of the sphincter

Question 26

what is a vagotomy?

Answer 26

when the vagus nerve is divided to the stomach to prevent gastric acid secretion

Question 27

how can acid secretion be reduced with medicines?

Answer 27

• H2 receptor blockers

- proton pump inhibitors

Question 28

how may the mucosal barrier be improved in PUD patients?

Answer 28

• eliminate helicobacter pylori

- inhibit prostaglandin removal

Question 29

what medicines should be avoided in patients with PUDs?

Answer 29

• NSAIDs

- steroids

Question 30

what 2 antibiotics are often used to eradicate bacteria causing PUD?

Answer 30

• amoxycillin

- metronidazole

Question 31

give an example of a proton pump inhibitor:

Answer 31

omeprazole