Gastric Ulcer Flashcards
Epidemiology
most common among middle-aged adults.
10% lifetime incidence
M>W slightly
Aetiology
Nearly all ulcers are caused by Helicobacter pylori infection or NSAID use
Cigarette smoking
stress
Pathogensis
A peptic ulcer is an erosion in a segment of the GI mucosa due to weakened mucosal defences
duodenal mucosa exists in the form of a gel layer, which is impermeable to acid and pepsin. Other gastric and duodenal cells secrete bicarbonate, which aids in buffering acid that lies near the mucosa. Prostaglandins of the E type (PGE) have an important protective role, because PGE increases the production of both bicarbonate and the mucous layer
Natural History
gastric cancer if untreated
Clinical Manifestations
Hpylori test.
Symptoms
burning epigastric pain that is often relieved by food - antiacids
often asymptomatic
Signs
use of NSAIDS/Aspirin
stool colour - bleeding
Complications
occult bleeding, perforation, haemorrhage, obstruction due to scarring,
3-6x increased risk of gastric cancer
Prognosis
The 3-yr recurrence rate for gastric and duodenal ulcers is 50% when it is not.
Life style changes/Stress management
cessation of NSAID treatments