Peptic Ulcer Disease

Question 1

What is the definition of peptic ulcer disease?

Answer 1

Peptic ulcer disease is an acid aggrevating stomach leision

Question 2

What type of disorder is Peptic Ulcer Disease? Where does it occur and the incidence of each location?

Answer 2

Peptic Ulcer Disease is an ulcerative disorder. It affects the stomach and the duodenum. 80 percent of cases are found in th duodenum and 20 percent are in the stomach.

Question 3

What layer of the GI lining is primarily affected in Peptic Ulcer disease?

Answer 3

Mucosa

Question 4

Can peptic ulcer disease affect layers other than the mucosa?

Answer 4

Yes.

Question 5

What is the typically disease pattern of peptic ulcer disease?

Answer 5

Remissions and Exacerbations

Question 6

What is the etiology of peptic ulcer disease?

Answer 6

Heliobacter Pylori Infection

Question 7

What are the three required elements for invasion and proliferation of the Heliobacter Pylori Infection in peptic ulcer disease?

Answer 7

1. Appropriate site where H. Pylori attached to cells in the stomach which produce mucosa. 2. Adhesion. 3. Urease produced by the H. Pylori.

Question 8

Explain the process of Urease and Helicobacter Pylori infection?

Answer 8

Urease is an enzyme produced by H. Pylori which breaks down urea into Ammonia NH3 and Carbon Dioxide CO2. When patient intakes water H2O the chemical components combine to form Carbonic Acid H2C03. Carbonic Acid is a volitile acid, and immediately breaks down and leaves us with Bicarbonate HC03. Bicardonate is able to neutralize stomach acid allowing the H. Pylori bacteria to survive.

Question 9

What are the two sources of damage in Peptic Ulcer Disease?

Answer 9

1. Inflammation. 2. Increased HCl secretions.

Question 10

What is hypergastrinemia?

Answer 10

Hypergastrinemia is an increase in the hormone gastrin which stimulates the production of hydrocholic acid.

Question 11

What risk factors of Peptic Ulcer Disease also exasberate the symptoms?

Answer 11

Smoking, Alcohol, Caffeine, Stress

Question 12

What are some associated risk factors thought to lead to the development of Peptic Ulcer Disease?

Answer 12

HCl and biliary acid. Steroids and NSAIDs, Chronic Gastritis. Smoking, Alcohol, Caffeine, and Stress are also risk factors. Additionally, they exasberate the symptoms.

Question 13

What is the Pathophysiology of Peptic Ulcer Disease?

Answer 13

Heliobacter Pylori infection. Infection causes inflammation and tissue damage. Additionally increased Gastrin production leads to increased HCl secretion and further tissue damage. The bodies defenses against gastric acid is impeded by the risk factors smoking, alcohol, NSAIDs, etc.

Question 14

What defensive mechanisims does the body have against Heliobacter Pylori bacteria and infection?

Answer 14

1. The body can regulate the secretion of gastrin. 2. If the patient has intact perfusion, it can help fight the infection. 3. The body is able to regenerate the epitheial lining of the mucosa.

Question 15

What manifestations will Peptic Ulcer Disease demonstrate?

Answer 15

Abdominal Pain, burning and cramping chronic, intermittent pain. Nausea and Vomiting GI manifestation, not from the abdominal pain.

Question 16

What are the three main complications of Peptic Ulcer Disease?

Answer 16

Perferation, Heborrhage, Gastric Obstruction

Question 17

In Peptic Ulcer Disease, what is gastic obstruction due to?

Answer 17

Gastric Obstruction is caused by edema, spasm, or scar tissue contraction in the lumen of the GI.

Question 18

How do you diagnose Peptic Ulcer Disease?

Answer 18

Diagnosis is made by patient history, urea breath test UBT, serology, fecal Ag antigens, barium swallow, and endoscopy.

Question 19

How does a Urea Breath Test work?

Answer 19

Patients swallow urea labelled with a radioactive carbon-14 atom. In the subsequent 10-30 minutes the detection of the isotope labelled carbon dioxide is exhaled it indicates that the urea was split by a urease enzyme produced by H. Pylori, and hence the presence of H. Pylori bacteria in the stomach.

Question 20

What is the treatment for Peptic Ulcer Disease?

Answer 20

Treatment for PUD involves treating for the H. Pylori bacteria and the acid reflux complications associated with the disease. First, an antacid will be used to neutrilize the PH of the acid. Secondly, patients will be put on a triple regiment: H2RA or PPI and also 2 Abx. Surgery may be conducted if complications such as perfusion occur.

Question 21

Can treatment cure Peptic Ulcer Disease?

Answer 21

Yes.