Author Topic: Peptic ulcer diseases!  (Read 23554 times)

0 Members and 1 Guest are viewing this topic.

Offline IsseGole

  • Global Moderator
  • *****
  • Posts: 86
  • Points: +15/-0
  • Gender: Male
  • I am going back to somalia, what about you?
    • Somali Medical student's forum
Peptic ulcer diseases!
« on: March 02, 2007, 10:13:34 AM »
Peptic ulcer disease (PUD)
Definition
Peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine (called the duodenum). Ulcers in the stomach are often called gastric ulcers. Ulcers in the duodenum are called duodenal ulcers.

Causes
Most peptic ulcers are caused by the bacteria Helicobacter pylori (H. pylori) or by using nonsteroidal anti-inflammatory drugs (NSAIDs). People infected with H. pylori and people who take NSAIDs do not all develop ulcers, though.

-Anything that upsets the balance of stomach acid and digestive juices can lead to an ulcer, such as the following:

1 H. pylori bacteria
2  NSAIDs, which hinder the body's ability to protect the stomach lining
3 Diseases that cause an increase in acid production, such as Zollinger-Ellison syndrome
4 Rare causes include radiation therapy, bacterial or viral infections, alcohol abuse, injury, and severe stress such as surgery, trauma, head injury, shock, or burns.

Risk Factors
A risk factor is something that increases your chances of getting a disease or condition.

Risk factors for ulcer from H. pylori infection include the following:

1 Age: 60 or older
2 Sex: Male
3 Race: Black and Hispanic
4 Lower socio-economic group
5 A crowded and unsanitary living environment
6 Cigarette smoking
7 Stress
8 Excess coffee drinking
9 Family history of ulcer disease
10 Type O blood

Risk factors for ulcer from anti-inflammatory drugs include the following:

1 Age: 60 or older
2 Sex: Male
3 History of stomach upset from NSAIDs
4 Prior peptic ulcer disease
5 Cigarette smoking
6 Alcohol abuse
7 Stress

Symptoms
Peptic ulcers do not always cause symptoms. Symptoms may come and go. Food may increase gastric ulcer pain, but food usually relieves duodenal ulcer pain.

Symptoms include the following:

1 Gnawing pain
2 May awaken you from sleep
3 May change when you eat
4 May last for a few minutes or several hours
5 Feels like unusually strong hunger pangs
6 Nausea
7 Vomiting
8 Loss of appetite
9 Bloating
10 Burping
11 Ulcers can result in serious complications and severe abdominal pain.

Complications include the following:

1 Bleeding, which may occur with no other symptoms. Symptoms of bleeding include:
Black, tarry stools
Vomiting up what looks like coffee grounds
Weakness
Dizziness
Anemia
2 Breaking through the wall of the stomach or duodenum (called a perforated ulcer). Sudden and severe pain is a common symptom of a perforated ulcer.
3 Scar tissue that narrows and eventually closes off the outlet of the stomach to the intestines. This blocks the passage of food through the digestive system. Symptoms of scar tissue blockage (obstruction) include the following:
Vomiting
Weight loss
Intense pain

Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tell your doctor about all medications that you are taking.

Tests may include:

1 Rectal exam and stool guaiac test–to test for hidden blood.

2 Blood test or breath test–to check for H. pylori infection. A blood test can also check for gastrin levels if Zollinger-Ellison syndrome is suspected.

3 Upper GI series–a series of x-rays of the upper digestive system taken after drinking a barium solution.

4 Endoscopy–a thin, lighted tube inserted down the throat to look inside the digestive tract. During the procedure, the doctor can take tissue samples to test for H. pylori infection or for cancer. Endoscopy is also helpful to eliminate other serious causes of gastrointestinal symptoms.

Treatment
The goals of treatment are to eliminate the source of the problem and heal the ulcer. Gastric ulcers may take longer to heal than duodenal ulcers.

Treatments include the following:

Medication
Some medications block or reduce acid production and some coat the ulcer, protecting it. If H. pylori caused the ulcer, you will need to take a combination of drugs to eliminate the bacteria. This usually consists of at least 2-3 antibiotics and a bismuth-containing drug and/or a proton-pump inhibitor. It is very important to take these drugs exactly as directed. The doctor may order tests 6-12 months after treatment to verify that the bacteria are gone.

Medications may include the following:

1 Antacids (don't heal ulcers, but may provide some relief from heartburn.)
2 Antibiotics (amoxicillin, tetracycline, and clarithromycin)
3 Bismuth-containing drug (Pepto-Bismol)
4 Proton pump inhibitors (to decrease stomach acid production (omeprazole, lansoprazole)
5 H2 blockers (to decrease stomach acid production (famotidine, ranitidine, cimetidine, nizatidine)
6 Medications to protectively coat ulcer (sucralfate)
7 Medications to protect stomach against NSAID damage (misoprostol)

Lifestyle Changes
1 If you smoke, quit. Smoking interferes with ulcer healing.
2 Do not drink alcoholic beverages.
3 Avoid NSAIDS, including over-the-counter drugs like aspirin and ibuprofen.
4 If spicy or fatty foods increase symptoms, you can temporarily stop eating them. Keep in mind they did not cause the ulcer and probably do not affect ulcer healing.
5 If stress increases ulcer pain, learn and practice stress-management techniques.

Surgery
Surgery may be necessary if you have bleeding, a perforation, or an obstruction. Surgical options include the following:

1 Endoscopic surgery–may be done to stop bleeding. In this procedure, a thin, lighted tube is inserted down the throat into the stomach or intestine. Then, heat, electricity, epinephrine, or a substance called “fibrin glue” can be applied to the area of bleeding to help stop the blood flow.
2 Vagotomy and drainage–vagotomy is the cutting of branches of the vagus nerve. Cutting the vagus nerve can greatly reduce acid production. Cutting through the entire nerve, though, can also interfere with the stomach’s ability to empty itself. Therefore, a means of drainage must be created. Drainage may be done with one of the following:
-Pyloroplasty–widening of the opening between the stomach and the first part of the small intestine (called the duodenum), allowing stomach contents to flow more easily into the intestine.
Gastroduodenostomy–creation of a new opening to connect the stomach and the duodenum.
Gastrojejunostomy–creation of a new opening to connect the stomach and the jejunum (the second part of the small intestine).
Highly elective vagotomy–a technique that cuts only part of the vagus nerve. This type of surgery does not require extra means of drainage.
Vagotomy with antrectomy–cutting of the vagus nerve combined with removal of the lower part of the stomach (antrum). The antrum produces a chemical that promotes acid production. Without that chemical, acid production drops.

Prevention
To decrease risk of ulcer from H. pylori infection:

1Wash your hands after using the bathroom and before eating or preparing food.
2 Drink water from a safe source.
3 Don't smoke. Cigarette smoking increases the chances of getting an ulcer.

To decrease the risk of ulcer from NSAIDs:
1 Use other drugs when possible for managing pain.
2 Take the lowest possible dose.
3 Do not take longer than needed.
4 Do not drink alcohol while taking the drugs.
5 Ask your doctor about switching to a newer NSAID that is less likely to cause 6 ulcers, or about taking other drugs to protect your stomach and intestine lining.
7 Don't smoke. Cigarette smoking increases the chances of getting an ulcer.


Towards a better healthy Somalia!!
Unless all parts of the society participate equally in the health process, nothing could be expected.


Offline Abrillgreen

  • Newbie
  • *
  • Posts: 4
  • Points: +0/-0
  • Gender: Female
Re: Peptic ulcer diseases!
« Reply #1 on: July 08, 2010, 08:38:31 AM »
The medical amount of alleviative comestible abscess and its complications runs in the billions of dollars annually. Recent medical advances accept added our compassionate of abscess formation. Improved and broadcast analysis options are now available.


 

Study common diseases (Differential diagnosis of malaria by clinical features)

Started by Dr.HabiibBoard Clinical Rotations

Replies: 3
Views: 38049
Last post May 07, 2011, 08:55:42 PM
by Waxbaro!
Study common diseases (Differential diagnosis of Cholera by clinical features).

Started by Dr.HabiibBoard Clinical Rotations

Replies: 0
Views: 29631
Last post October 15, 2011, 08:17:31 PM
by Dr.Habiib
Internship - HTM - HIV/AIDS, TB, Malaria and Negleted Tropical Diseases (WHO)

Started by AdminBoard Internship and Residency

Replies: 0
Views: 16704
Last post November 30, 2010, 06:07:18 PM
by Admin
Study common diseases and discussing all of things about this disease.

Started by Dr.HabiibBoard Clinical Rotations

Replies: 4
Views: 20519
Last post April 23, 2011, 09:01:37 PM
by Diagnostic
health lifestyle halve the risks of many diseases

Started by Dr.FarabadanBoard Health News and Events

Replies: 0
Views: 4855
Last post September 17, 2008, 01:51:10 PM
by Dr.Farabadan