Peptic ulcer disease Flashcards
What is the cause of peptic ulcer disease?
High acid secretion passing into the duodenum/oesophagus- burning the mucosa, the stomach can lose ability to defend itself against acid attack, or drugs such as NSAIDs
How does helicobacter pylori cause peptic ulcers?
Results in loss of mucus barrier, allowing acid in stomach to get at gastric wall and cause peptic ulcer
What are some effects of helicobacter pylori?
Gastric ulcers, chronic gastric wall inflammation, lymphoma of the stomach
What is stomach lymphoma caused by H.pylori?
Mucosa associated lymphoid tumour which disappears when the cause is removed
How is H.pylori eliminated?
Lymphoma patients- just antibiotics
Triple therapy- 2 antibiotics and 1 proton pump inhibitor for 2 weeks then test after with endoscopy and biopsy or breath test
What are some signs and symptoms of peptic ulcer disease?
Can be asymptomatic, epigastric burning pain- worse at night, before/right after meals and relieved by food, antacids or vomiting.
Usually no physical signs unless there is complications e.g. bleeding, perforation of ulcer to peritoneum and changes to haemodynamic status of patient
How is peptic ulcer disease investigated?
Endoscopy, radiology with barium, for anaemia do FBC and faecal occult blood test, and for H,pylori breath test or endoscopy + biopsy to check the antibodies against the bacteria found in blood.
What are some complications of peptic ulcer disease?
Local- perforation, haemorrhage, stricture, malignancy
Systemic- anaemia
What can you do to improve mucosal barrier?
Eliminate helicobacter pylori, inhibit prostaglandin removal by avoiding NSAIDs and reduce steroid use
What are some surgeries you can do for peptic ulcer disease?
Bilroth 1-removal of the sphincter, bilroth 2-reconnecting top half of stomach to the small bowel and highly selective vagotomy
