Peptic Ulcer Disease Flashcards
what is peptic ulcer disease?
ANY acid affected site
where can peptic ulcer disease occur?
- oesophagus
- stomach
- duodenum
what are the causes of peptic ulcer disease?
- too much acid secreted
- acid secreted into the wrong place
what drugs can cause peptic ulcer disease?
- NSAIDs
- steroids
what causes a gastric ulcer?
gastric inflammation
what complications can arise from gastric or duodenal ulcers?
- bleeding ulcer
- perforated ulcer
where would you find a gastric ulcer?
in the stomach
what is occurring when peptic ulcer disease occurs from a normal acid secretion?
involvement of bacteria which causes a reduced protective barrier
what bacteria is involved in peptic ulcer disease?
Helicobacter pylori
what does infection with bacteria eventually cause?
causes loss of the protective mucous barrier
how does the bacteria affect the gastric mucosa?
causes inflammation of the gastric mucosa (gastritis)
what can occur from chronic gastric wall inflammation due to bacteria?
lymphoma of the stomach (mucosa associated lymphoid tumour)
how can peptic ulcer disease causing bacteria be eliminated??
WITH TRIPLE THERAPY
- 2 antibiotics
- 1 proton pump inhibitor
what are the signs and symptoms of PUD?
- often asymptomatic
- epigastric burning pain
- usually no physical signs
explain the epigastric pain felt by patients experiencing PUD?
- worse before/just after meals
- worse at night
- often relieved by food, alkali & vomiting
how is PUD investigated?
- endoscopy (preferred)
- radiology
- test for anaemia (FOBs)
what are the complications of PUD?
- perforation
- haemorrhage
- stricture
- malignancy
- anaemia
what is meant by perforation caused by PUD?
the acid burns a hole in the wall of the stomach/duodenum
what happens if a haemorrhage occurs due to PUD?
erosion of the ulcer into a blood vessel, causing heavy bleeding
what happens when stricture occurs?
- scarring makes the space (stomach/duodenum) smaller
why might anaemia occur in PUD patients?
due to bleeding caused by the ulcer
what are some MEDICAL treatments for PUD?
- stop smoking
- small regular meals
- ulcer healing drugs
- eradication therapy
when is it appropriate to go down the MEDICAL route for PUD?
when the PUD is:
- a reversible problem
- can be fixed by making lifestyle changes
- due to presence of H. pylori
when is SURGICAL treatment necessary in PUD patients?
when PUD has caused:
- stricture
- acute bleed
- perforation
- malignancy
what surgical procedures can be used in PUD?
- endoscopy
- gastrectomy
- vagotomy
- repair of the sphincter
what is a vagotomy?
when the vagus nerve is divided to the stomach to prevent gastric acid secretion
how can acid secretion be reduced with medicines?
- H2 receptor blockers
- proton pump inhibitors
how may the mucosal barrier be improved in PUD patients?
- eliminate helicobacter pylori
- inhibit prostaglandin removal
what medicines should be avoided in patients with PUDs?
- NSAIDs
- steroids
what 2 antibiotics are often used to eradicate bacteria causing PUD?
- amoxycillin
- metronidazole
give an example of a proton pump inhibitor:
omeprazole
