Flashcards in Peptic Ulcer Deck (21):
What kind of disease is it when you have a Peptic Ulcer?
Where do peptic ulcers occur?
Stomach (20%) and Duodenum (80%)
This is because acid buffers are coming through from the pancreas.
What layer does it affect mostly and what is the prevalence?
Primarily impacts the mucosa BUT can penetrate.
Remission and exacerbations
Et. of Peptic Ulcer disease
H. Pylori or (Hecilobacter pylori)
Site and adhesion= proteins that attach to the epithelial lining.
How do the H. Pylori survive?
H. Pylori make urease which breaks down urea into ammonia and carbon dioxide..this broken down form of urea is a barrier to HCl and neutralizes the acid.
Mnfts of Peptic Ulcer disease
Pain, nausea, burning, cramping, vomiting.
Complications of Peptic Ulcer disease
Perforation causing Peritonitis
Hemorrhage (occult blood)
Obstruction of the bowel ( d/t edema, spasm or scar tissue from healing)
Risk factors of Peptic Ulcer disease
HCl and biliary acid
NSAIDS (too much can cause ulcers)
Caffeine, alcohol and smoking
Patho of Peptic Ulcer Disease
Role of H pylori is not clear
(Infection, inflam, tissue damage)
(increased gastrin, increased acid, tissue damage)
Risk factors impede defences against gastric acid
Dx of Peptic Ulcer Disease
What are we looking for in Serology for suspected Peptic Ulcers?
Antibodies in the blood for H.pylori
Describe the UBT
Urea with high concentrations of C14 (radioactive and measurable) are ingested. Once ingested, if H.pylori is present, Carbon levels will rise as urea is being broken down into more carbon molecules. If not, H.pylori is not present.
What is the Barium Swallow?
Contrast medium to detect ulcers
Tx for Peptic Ulcers
Anti-acids (neutralize the acid, OTC)
Triple regimen. PPI with 2 antibiotics or H2RA with 2 antibiotics.
What are some H2RA?
Zantac and Tagamet
What does a H2RA do?
It blocks the production of histamine in the parietal cells which decreases the production of acid
What are two antibiotics that go with H2RA
Flagyl and Biaxin
What does a Proton Pump Inhibitor do?
Blocks the secretion of HCl
If complications occur such as (obstruction, perforation and hemorrhage) what treatment should take place?
How long do you take the triple regimen for?
About 2 weeks