Transcript 2. Peptic ulcer disease

Peptic ulcer disease
Peptic ulcer disease
• A peptic ulcer is a break in the inner lining of
the esophagus, stomach, or duodenum. A
peptic ulcer of the stomach is called a gastric
ulcer; of the duodenum, a duodenal ulcer; and
of the esophagus, an esophageal ulcer. Peptic
ulcers occur when the lining of these organs is
corroded by the acidic digestive (peptic) juices
which are secreted by the cells of the stomach.
Peptic ulcer disease
Signs and symptoms:
• abdominal pain, classically epigastric with severity relating
to mealtimes, after around three hours of taking a meal
(duodenal ulcers are classically relieved by food, while
gastric ulcers are exacerbated by it)
• bloating and abdominal fullness;
• Acid reflux
• nausea, and vomiting;
• loss of appetite and weight loss
• hematemesis (vomiting of blood); this can occur due to
bleeding directly from a gastric ulcer, or from damage to
the esophagus from severe/continuing vomiting.
Peptic ulcer disease
• Diagnosis:
• The diagnosis is mainly established based on the
characteristic symptoms. Stomach pain is usually the first
signal of a peptic ulcer. In some cases, doctors may treat
ulcers without diagnosing them with specific tests and
observe whether the symptoms resolve, thus indicating
that their primary diagnosis was accurate.
• Confirmation of the diagnosis is either by an upper
intestinal endoscopy, which allows direct examination of
the ulcer through a fiberoptic instrument (endoscope), or
by a barium x-ray of the stomach. With endoscopy, a
biopsy is usually obtained of a gastric ulcer.
Peptic ulcer disease
• Treatment:
• If the peptic ulcer caused by infection with Helicobacter
pylori (H. pylori) bacteria, treatment with antibiotic
medicines to kill the bacteria.
• If ulcer is caused by the use of drugs , stop using them.
• Medicines that reduce the amount of acid produced by the
stomach are used to treat all forms of peptic ulcer disease.
• Lifestyle changes, such as quitting smoking and not drinking
too much alcohol, are important for helping ulcers heal.
• Because the medicines now used to treat peptic ulcer
disease work so well, surgery is rarely used to treat peptic
ulcer disease. Surgery generally is reserved for people who
have a life-threatening complication of an ulcer, such as
severe bleeding, perforation, or obstruction.
Peptic ulcer disease
Prevention:
• Stop smoking.
• Eat a high fiber diet
• Avoid food that irritates the stomach.
• Avoid alcohol.
• Avoid caffeine.
• Avoid aspirin.
• Avoid anti-inflammatory medications:
– Ibuprofen
– Naproxen
– Ketoprofen
• Eat small meals more frequently.