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Peptic Ulcer Disease PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Peptic Ulcer Disease” by Dr Amit Gupta.

This medical PowerPoint presentation is about peptic ulcer disease (PUD), a condition in which open sores, known as ulcers, develop in the lining of the stomach, esophagus, or small intestine. Peptic ulcers are typically caused by an imbalance of digestive juices and stomach acid, which can erode the protective lining of the digestive tract.

The most common symptom of PUD is a burning or gnawing pain in the upper abdomen, which may be accompanied by nausea, vomiting, bloating, or a feeling of fullness. The pain may be worse at night or between meals and can last for minutes to hours.

The two main causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Other factors that may contribute to the development of PUD include smoking, stress, and heavy alcohol use.

Treatment for PUD typically involves a combination of medications to reduce stomach acid and kill H. pylori, if present. Lifestyle changes such as quitting smoking, avoiding alcohol and caffeine, and eating a healthy diet can also help manage the condition. In severe cases, surgery may be necessary to repair the ulcer or remove part of the stomach or small intestine.

Tags : peptic ulcer disease, esophagus, small intestine, bacterium Helicobacter pylori, H. pylori, non-steroidal anti-inflammatory drugs, NSAIDs, Gastroenterology, Gastroenterology PowerPoint presentation

Published on : May 02, 2023 | Views : 1567 | Downloads : 7

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Slide 1-

Peptic Ulcer Disease Dr. Amit Gupta Associate Professor Dept. of Surgery
Slide 2-

Introduction Erosion of GI mucosa resulting from digestive action of HCl and pepsin Site Lower esophagus Stomach Duodenum 10% of men, 4% of women
Slide 3-

Types Acute Superficial erosion Minimal erosion Chronic Muscular wall erosion with formation of fibrous tissue Present continuously for many months or intermittently
Slide 4-

Etiology and Pathophysiology Develop only in presence of acid environment Excess of gastric acid not necessary for ulcer development Person with a gastric ulcer has normal to less than normal gastric acidity compared with person with a duodenal ulcer Some intraluminal acid does seem to be essential for a gastric ulcer to occur Pepsinogen is activated to pepsin in presence of HCl Secretion of HCl by parietal cells has a pH of 0.8 pH reaches 2 to 3 after mixing with stomach contents
Slide 5-

At pH level 3. 5 or more, stomach acid is neutralized Surface mucosa of stomach is renewed about every 3 days Mucosa can continually repair itself except in extreme instances Mucosal barrier prevents back diffusion of acid from gastric lumen through mucosal layers to underlying tissue Mucosal barrier can be impaired and back diffusion can occur
Slide 6-

Diffusion of Acid
Slide 7-

Disruption of Gastric Mucosal Barrier
Slide 8-

Protective Mechanism Mucus forms a layer that entraps or slows diffusion of hydrogen ions across mucosal barrier Bicarbonate secreted Neutralizes HCl acid in lumen of GI tract
Slide 9-

Gastric Ulcers Characterized by A normal to low secretion of gastric acid Back diffusion of acid is greater (chronic ) Critical pathologic process is amount of acid able to penetrate mucosal barrier H pylori is present in 50% to 70% Drugs --- Aspirin, corticosteroids, N SAIDs, reserpine, Chronic alcohol abuse, chronic gastritis
Slide 10-

Duodenal Ulcers Between ages of 35 to 45 years Account for 8 0% of all peptic ulcers Associated with ↑HCl acid secretion H.pylori associated in 9 0- 9 5 % of cases Diseases with ↑risk of duodenal ulcers COPD, cirrhosis of liver, chronic pancreatitis, hyperparathyroidism, chronic renal failure
Slide 11-

Clinical Features Common to have no pain or other symptoms Gastric and duodenal mucosa not rich in sensory pain fibers Duodenal ulcer pain Burning, cramplike Gastric ulcer pain Burning, gaseous
Slide 12-

Complications 3 major complications Hemorrhage Perforation Gastric outlet obstruction Initially treated conservatively May require surgery at any time during course of therapy
Slide 13-

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Slide 14-

Diagnostic Studies Endoscopy procedure Determines degree of ulcer healing after treatment Tissue specimens can be obtained to identify H. pylori and to rule out gastric cancer Tests for H.pylori Noninvasive tests Serum or whole blood antibody tests Immunoglobin G (I g G) Urea breath test C 14 breath test Invasive tests Biopsy of stomach Rapid urease test
Slide 15-

Barium contrast studies Widely used X- ray studies Ineffective in differentiating a peptic ulcer from a malignant tumor Gastric analysis Lab analysis
Slide 16-

Treatment Medical regimen consists of Adequate rest Dietary modification Drug therapy Elimination of smoking Long-term follow-up care Aim of treatment pro g ram ↓ degree of gastric acidity Enhance mucosal defense mechanisms Minimize harmful effects on mucosa
Slide 17-

Drug Therapy Antacids H2 receptor blockers PPIs Antibiotics Anticholinergics Cytoproctective therapy
Slide 18-

Histamine receptor blocks (H2 R blockers) Used to manage peptic ulcer disease Block action of histamine on H2 receptors ↓ HCl acid secretion ↓ conversion of pepsinogen to pepsin ↑ ulcer healing Proton pump inhibitors Block ATPase en zyme that is important for secretion of HCl acid Antibiotic therapy Eradicate H. pylori infection No single agents have been effective in eliminating H. pylori
Slide 19-

Antacids Used as adjunct therapy for peptic ulcer disease ↑ gastric pH by neutralizing acid Anticholinergic drugs Occasionally ordered for treatment ↓ cholinergic stimulation of HCl acid Cytoprotective drug therapy Serotonin reuptake inhibitors
Slide 20-

Nutritional therapy Dietary modifications may be necessary so that foods and beverages irritating to patient can be avoided or eliminated Nonirritating or bland diet consisting of 6 small meals a day during symptomatic phase Protein considered best neutralizing food Stimulates gastric secretions Carbohydrates and fats are least stimulating to HCl acid secretion Do not neutralize well
Slide 21-

Surgical Treatment < 20% of patients with ulcers need surgical intervention Indications for surgical interventions Intractability History of hemorrhage, ↑ risk of bleeding Prepyloric or pyloric ulcers Multiple ulcer sites Drug-induced ulcers Possible existence of a malignant ulcer Obstruction
Slide 22-

Surgical procedures Gastroduodenostomy Gastrojejunostomy Vagotomy Pyloroplasty
Slide 23-

A. Billroth I Procedure B. Billroth II Procedure
Slide 24-

Comply with prescribed therapeutic regimen Experience a reduction or absence of discomfort related to peptic ulcer disease Exhibits no signs of GI complications Have complete healing Lifestyle changes to prevent recurrence Goals