Chronic Gastritis And Peptic Ulcers Flashcards
1
Q
Stomach aggressive mechanisms
A
- Corpus; acid and pepsin formation
- parietal cells form HCL and intrinsic factors. Intrinsic factors absorb B12 (used for cell division of RBCs)
- chief and mucous cells form pepsinogen which is converted to pepsin by HCLs action, then pepsin can break down proteins
- Antrim (bottom of stomach); G cells form gastrin to stimulate parietal cells.
2
Q
Protective mechanisms of stomach
A
- bicarbonate produced in stomach for neutralisation
- mucous layer formed on mucosa
- prostaglandins - prevent damage to cells
3
Q
Protective mechanisms of duodenum
A
- bicarbonate formed from the pancreas
- if gastric emptying time is rapid, build up of acid in duodenum.- gastric emptying time is protective
4
Q
Epidemiology
A
- men more likely
- middle age
- single ulcer more common
- developing society
- duodenal more common than stomach ulcers
- can have an ulcer in both
5
Q
Aetiology
A
- Helicobacter pylori forms 90% of ulcers
- forms urease- catalyses urea to ammonia (base), so acid cannot digest it. This results in inflammation causing an immune response.
- increases HCL secretion, which impairs duodenal bicarbonate production- aggressive mechanisms increased, protective decreased - more likely to digest own stomach
- slow accumulation, not all helicobacter pylori result in gastric ulcers
- other factors are stress, NSAIDs, smoking, alcohol
6
Q
Duodenal ulcers (peptic ulcers)
A
Anterior wall- 1 cm from pylorous.
- increased acid and pepsin
- rapid gastric emptying
- granulation tissue at base of ulcer
Complications:
- pain
- haemorrhage - anaemia or death
- scarring- stricture (narrowing lumen due to scar, causing contracture) - obstruction or sphincter incompetence
- perforation - peritonitis
7
Q
Gastric ulcers (stomach ulcers)
A
- low to normal acid, decreasing mucus
- chronic gastritis- scarring- sphincter incompetence- bile reflux
- occurs in the lesser curvature of Antrum
