Gastro - Peptic Ulcers Flashcards
What do peptic ulcers involve?
Gastric ulcers
Duodenal ulcers
What is the pathophysiology of peptic ulcers?
Disruption to the mucus membrane
Increased stomach acid
What are the key risk factors that disrupt the mucus barrier?
Helicobacter Pylori
NSAIDS
What are the key risk factors that increase stomach acid?
Stress
Alcohol
Caffeine
Smoking
Spicy food
What can increase the risk of bleeding from a peptic ulcer?
NSAIDs
Aspirin
Anticoagulants
Steroids
SSRIs
How do peptic ulcers present?
Epigastric pain
Nausea and vomiting
Dyspepsia
What are the signs of upper GI bleeding?
Haematemesis
Coffee ground vomiting
Melaena
Fall in Hb
What does chronic microscopic bleeding lead to?
Iron deficiency anaemia
Low Hb
Low MCV
Low ferritin
How does eating affect peptic ulcers?
Worsens gastric ulcers
Improves duodenal ulcers immediately after eating, pain 2-3 hours later
Do patients with peptic ulcers lose weight?
Gastric
Afraid to eat causing weight loss
Duodenal
Stable
How are peptic ulcers diagnosed?
Endoscopy
Rapid urea test
How are peptic ulcers managed?
Stopped NSAIDs
Treat H.pylori infection
PPIs
Repeat endoscopy at 4-8 weeks
What are the complications of peptic ulcers?
Bleeding
Perforation causing acute abdominal pain and peritonitis
Scarring and strictures
What do scarring and strictures cause?
Gastric outlet obstruction
- Early fullness after eating
- Upper abdominal discomfort
- Abdominal distension and vomiting
How are scarring and strictures treated?
Balloon dilatation during endoscopy or surgery
