peptic ulers Flashcards
what are the 2 different types of peptic ulcers?
- gastric ulcer- stomach
- duodenal ulcer- ulcer in duodenum- more common
which drugs can increase risk?
NSAIDs
steroids
which other things can increase acid?
Stress Alcohol Caffeine Smoking Spicy foods
which ulcers improve with eating?
duodenal
which ulcers get worse with eating?
gastric
what is the presentation of a peptic ulcer?
Epigastric discomfort or pain
Nausea and vomiting
Dyspepsia
Bleeding causing haematemesis, “coffee ground” vomiting and melaena
Iron deficiency anaemia (due to constant bleeding)
what is a CLO test?
A test preformed during endoscopy to check for H.pylori
what investigations need to be done for peptic ulcers?
endoscopy-> with H pylori test and biopsy to exclude malignancy
what are complications of peptic ulcer disease?
Bleeding from the ulcer is a common and potentially life threatening complication.
Perforation resulting in an “acute abdomen” and peritonitis. This requires urgent surgical repair (usually laparoscopic).
Scarring and strictures of the muscle and mucosa. This can lead to a narrowing of the pylorus (the exit of the stomach) causing difficulty in emptying the stomach contents. This is known as pyloric stenosis.
what is H.pylori?
Approximately 90% of duodenal ulcers are caused by H. Pylori infection.
This is a gram negative bacterium that buries itself into the gastric epithelium and releases urease that neutralises the pH of the stomach and damages the epithelium.
what is the pre-endoscopy guidance for investigating a H.pylori case?
The patient should not have taken antibiotics or bismuth products for four weeks and no PPI for two weeks before H. Pylori diagnosis.
what’s the treatment for H.pylori?
triple therapy:
Amoxicillin, clarithromycin and a PPI twice daily for seven days
