GS Gastric ulcer treatment

Question 1

How does Bisodol work?

Answer 1

• Stimulates enteric nerves to cause colonic contractions. It is also a contact laxative; it increases fluid and salt secretion

Question 2

How does ranitidine work?

Answer 2

An oral drug that blocks the production of acid by acid-producing cells in the stomach. It belongs to a class of drugs called H2 (histamine-2) blockers that also includes cimetidine (Tagamet), nizatidine (Axid), and famotidine (Pepcid)

Question 3

What controls acid secretion in the stomach?

Answer 3

Cells of the gastric mucosa are involved in gastric secreted
Gastrin, ACh, histamine and PS nervous supply all stimulate gastric secretions
Gastric secretion includes the acidic HCl from parietal cells
HCl secretion by H+ (via the H+-K+ ATPase) and Cl- (by diffusion) separate secretion from gastric parietal cells at apical surface
2 phases of secretion: Cephalic (30%) and Gastric (60% due to more stimuli) and intestinal (10%).
o Cephalic is reflex in anticipation of food.
o Gastric is due to distension of stomach plus presence of breakdown products in stomach.
o Intestinal is due to presence of breakdown products of proteins in the duodenum.
2 vagal pathways for stimulation, direct and indirect.
o Direct means vagal release of Ach activate parietal cells.
o Indirect means vagal release of gastrin from G cells in stomach, then stimulate parietal cells.

Question 4

Why does alcohol aggravate a stomach ulcer?

Answer 4

• Alcohol causes stomach to produce more acid than usual, leading to possible gastritis.
• Gastritis leads to stomach pain, vomiting, diarrhoea and even bleeding

Question 5

How do you test for H. pylori?

Answer 5

4 tests:

1. Blood antibody test: Have antibodies to H. pylori been produced?
2. Urea breath test: Have you got H. pylori in stomach?
3. Stool antigen test: Checks to see if substances that trigger theimmune systemto fight anH. pyloriinfection (H. pyloriantigens) are present in your faeces
4. Stomach biopsy

Question 6

Why does H. pylori cause stomach ulcers?

Answer 6

• H. pylori bacteria burrow into the cells of the stomach lining and cause damage/inflammation. Resulting in gastritis.
• This stomach lining usually protects you from HCl. It’s the acid that causes the ulcers to form

Question 7

Explain the drug regime that Mr Allsop has been prescribed.

Answer 7

• Amoxycillin: Antibiotic to treat infection
• Metronidazole: Antibiotic to treat infection
• Omeprazole: Proton pump inhibitors to treat symptoms of GORD. Works by suppressing stomach acid secretion by specific inhibit of the H+/K+ ATPase system found in the parietal cells of the stomach