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10 Cards in this Set
- Front
- Back
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Define Ulcer
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lesion
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What is the incidence of Peptic Ulcers? (%)
Where do they occur? (%) |
~10% incidence
-20% of cases = Stomach -80% of cases = Duodenum |
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Which layers of the stomach/ duodenum walls do Peptic Ulcers affect?
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Mucosa
(can extend into deeper layers in duodenum d/t acid) |
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Etiology (3)
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-100% curable
RISK FACTORS -Defensive factors (musous layer against acid, buffering in pancreas) < Offensive factors (stress, NSAIDs) = inc. risk CAUSE: -H. Pylori (Helicobacter pylori) infection *If infection present - risk factors determine extent |
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Pathology
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H. Pylori infection
=inflammatory mediator release =tissue damage (in stomach or duodenum) |
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Why does Helicobacter Pylori cause ulcers?
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-can survive an acid environment
-cause hypergastrinemia (inc. secretion of gastrin hormone which inc. HCL secretion) =inc. HCL =tissue damage |
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Manifestations (4)
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-burning
-cramping abdominal pain (primary presentation) -nausea -vomiting |
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Complications (3)
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-Bleeding - d/t blood vessel damage = hemorrhage
-Perforation of stomach/ duodenum (not d/t pressure, hole is actually formed) = peritonitis -Gastric/duodenal obstruction - d/t edema, spasm, or scar tissue contraction |
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Diagnostics
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-Hx & Px
-Serology (looking for & measuring antibodies) -Fecal antigen sample testing -UBT (Urea Breath Test): urea (broken down by urase) = CO2 + NH2 (ammonia); Pt given carbon 13 or 14 to ingest; 2hrs later pt. blows into bag (CO2 exhaled); levels show if ukase is present in bacteria -Barium swallow: pt ingests barium; goes through GI tract; X-ray (barium allows visualization of ulcers) -Endoscopy: like a colonoscopy but via mouth |
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Treatment
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CURE:
-Antibiotics for bacterial infection -triple regime to eradicate peptic ulcers: PPIs (proton pump inhibitors) (block H+ secretion - losec, pariet, nexium) + 2 antibiotics (amoxycillin & biaxin for 7-10 days) OR H2RAs (H2 Receptor Antagonists) (block gastric secretion - tagamet, zantac) + 2 antibiotics (amoxicillin & biaxin for 7-10 days) -antacids treat symptoms -surgery may be necessary for complications (i.e. gastric obstruction or for draining ulcers) |
