Yr 2 GI- Gastric Ulceration Flashcards
What is common symptom of gastric ulcer?
Mild epigastric discomfort- (most common)
weight loss.
not wanting to eat because of pain.
nausea or vomiting.
bloating.
feeling easily full.
burping or acid reflux.
heartburn, which is a burning sensation in the chest)
What are antacids?
Antacids are medicines that counteract (neutralise) the acid in your stomach to relieve indigestion and heartburn. They come as a liquid or chewable tablets and can be bought from pharmacies and shops without a prescription.
The GP prescribes proton pump inhibitor for gastric ucleration.
What is the significance?
PPIs work by reducing the amount of acid your stomach produces, preventing further damage to the ulcer as it heals naturally. They’re usually prescribed for 4 to 8 weeks. Omeprazole, pantoprazole and lansoprazole are the PPIs most commonly used to treat stomach ulcers.
How does ibuprofen cause gastric ulceration?
NSAIDs such as aspirin, ibuprofen, and naproxen, can cause ulcers by interfering with the stomach’s ability to protect itself from gastric acids
By blocking the Cox-1 enzyme and disrupting the production of prostaglandins in the stomach, NSAIDs can cause ulcers and bleeding
- NSAIDs inhibit COX1 and 2, enzymes that are essential to prostaglandin synthesis - COX1 is expressed in the stomach and inhibition results in reduced mucosal blood flow and reduced mucosal defence
What are prostaglandins?
The prostaglandins are a group of lipids made at sites of tissue damage or infection that are involved in dealing with injury and illness. They control processes such as inflammation, blood flow, the formation of blood clots and the induction of labour
How does H. pylori cause (duodenal and gastric) ulceration?
H. pylori bacteria releases some virulence factors that go inside epithelial cells, weakens mucous, cause damage. The immune system causes inflammatory response causing gastritis. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer.
As long as this bacteria stays here it continues to damage leading to chronic gastritis (normal epithelium get damaged and repaired). thus allowing acid to get through to the sensitive lining beneath.
Over time stomach cells can metastasise. The metaplastic cells divide uncontrollably and cell invade and spread (malignant). This causes large irregular ulcers to form
Why would a repeat blood test for H. pylori be unhelpful?
Blood tests are used to measure antibodies to H pylori. Blood Tests It cannot tell if you have a current infection or how long you have had it. This is because the test can be positive for years, even if the infection is cured.
Also because the infection is more in the Infection of the GI tract than blood
How would an urea breath test be useful for assessing H. pylori infection?
Carbon-14 Urea Breath Test. This test checks to see if the presence of the bacteria Helicobacter Pylori is the cause of stomach problems. The test involves taking two breath samples and swallowing a radioactive tracer called carbon-14 (C-14).
Before the you ingest something- Carbon is radiolabelled so you know what carbon is produced
Swallow substance has a radioactive tag that you can monitor CO2
