- A break or cut which is painful that develops on the lining of the oesophagus, stomach or small intestine ( duodenum).
- Peptic ulcer disease (PUD) refers to chronic mucosal ulceration affecting the duodenum or stomach and is almost always associated with H. pylori infection, NSAIDs, or cigarette smoking.
- Peptic ulcer occurs in that part of the gastrointestinaltract (g.i.t.) which is exposed to gastric acid and pepsin.
Etiology or cause of peptic ulcer
peptic ulcer results probably due to an imbalance between the aggressive and the defensive factors.
The aggressive factors are Acid, pepsin , bile and H. pylori and
The defensive factors are–
- gastric mucus and bicarbonate secretion,
- prostaglandins,
- nitric oxide, high mucosaI blood flow, innate resistance of the mucosal cells.
Precautions~ :
-life style modifications like-
-Not missing breakfast in the morning
-Avoiding fast food and spicy food
-Doing daily exercise
TREATMENT ~-
(1) Acid-antisecretoryagents,
1. Proton pump inhibitors—
oral proton pump inhibitors
- Omeprazole
- Rabeprazole,
- Esomeprazole,
- Lansoprazole,
- Dexlansoprazole, and
- Pantoprazole.
(2) Mucosal protective agents, and
(3) Agents thatpromote healing through eradication of H. pylori.
what is risk factors for peptic ulcer ???
- Helicobacter pylori infection
• Cigarette use (synergizes with H. pylori for gastric PUD)
• Chronic obstructive pulmonary disease
• Illicit drugs, e.g., cocaine, that reduce mucosal blood flow
• NSAIDs (potentiated by corticosteroids)
other causes are ……
• Alcoholic cirrhosis (primarily duodenal PUD)
• Psychological stress (can increase gastric acid secretion)
• Endocrine cell hyperplasia (can stimulate parietal cell growth andgastric acid secretion)
• Viral infection (CMV, herpes simplex virus)
what is the symptoms of peptic ulcer disease ??
- Epigastric burning or aching pain
- Hemorrhage, or perforation
- Additional manifestations-
Nausea, vomiting, bloating, belching, and significant weight loss .
- If ulcer become penetrating type ( penetrating ulcer)then the pain is occasionally referred to the back, left upper quadrant, or chest.
what is the difference between gastric ulcer pain and duodenal ulcer pain??
- The duodenal ulcer pain tends to occur 1 to 3 hours after meals during the day, is worse at night (usually between 11 p.m. and 2 a.m.) and is relieved by alkali or food.
and
- gastric ulcer pain mainly occur after meal
what is the complications of PUD??
- Bleeding
- perforation
- obstruction