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Causes of peptic ulcers:

Helicobacterpylori(H.pylori)
Gramnegativebacteriatransferredfromcontaminatedfoodsorpersontoperson

Nonsteroidalantiinflammatorydrug(NSAID)andcorticosteroiduse
**ibuprofen

Severestress

Hypersecretorystates

TypeOblood

Excessalcoholingestion

Chronicpulmonaryorkidneydisease

ZollingerEllisonsyndrome(combinationofpepticulcers,hypersecretionofgastricacid,andgastrinsecretingtumors
Surgical Treatment:
Recommended for thosethatfailtohealafter12to16weeksofmedicaltreatment

Vagotomy:
Severing of the
Vagus Nerve
Maybeperformedto
reducegastricacid

Pylorplasty:
Longitudinal incision
is made into the
pylorus and
transversely sutured
closed to enlarge the
outlet and relax the
muscle
Management of Peptic Ulcer Disease
Antrectomy:
Removal of the
What is a Peptic Ulcer?lower portion of the
antrum of the
stomach (which
contains the cells
that secrete
gastrin) as well as a
small portion of the
Apepticulcermaybereferredtoasagastric,duodenal,oresophagealulcer,dependingonitslocation.Apepticulcerisanexcavation(hollowed
duodenum and
outarea)thatformsinthemucosalwallofthestomach,inthepylorus(theopeningbetweenthestomachandduodenum),intheduodenum(the
pylorus.
firstpartofthesmallintestine),orintheesophagus.
Anindividualwhohasapepticulcerhaspepticulcerdisease(PUD).Therearegastriculcers,duodenalulcers,andstressulcers.
Medical Treatment Medical Treatment
Signs & Symptoms

Proton pump inhibitors Antibiotcs


suppress the secretion of hydrochloric chemical that is able to inhibit the
acid into the lumen of the stomach. growth of specified bacteria or cause the
Examples: omepra- zole (Prilosec), death of susceptible bacteria.
esomeprazole (Nexium), lansoprazole Examples: metronidazole (Flagyl)or
(Prevacid), dexlansoprazole (Kapidex), amoxicillin (Amoxil) and
pantoprazole (Protonix), and rabeprazole. clarithromycin (Biaxin)

Management Histamine 2 Antagonist


block the release of hydrochloric acid in
Drinkalcoholinmoderation.
response to gastrin.
Stopsmokinganduseoftobacco
Examples: cimetidine (Tagamet),
products.
ranitidine (Zantac), famotidine (Pepcid),
Usestressmanagementtechniques.
and nizatidine (Axid). Complications
AvoidNSAIDSasindicated.
Limitcaffeinecontainingbeverage When peptic ulcers perforate
Lyingdownafteramealslowsthe
Antacids
or bleed, it is an emergency
movementoffoodwithintheintestines. are a group of inorganic chemicals that
situation.
Limittheamountoffluidingestedatone neutralize stomach acid. Dumping syndrome is a group
time. Examples: sodium bicarbonate (Bell-
of manifestations that occur
Eliminateliquidswithmeals,for1hr ans), calcium carbonate (Oystercal,
following eating. A shift of fluid
priorto,andfollowingameal. Tums, and others), magnesium salts
(Milk of Magnesia and others), to the abdomen is triggered by
Consumeahighprotein,highfat,low
aluminum salts (Amphojel and others), rapid gastric emptying or high-
fiber,andlowtomoderatecarbohydrate
diet. and magaldrate (Riopan). carbohydrate ingestion
(Aciphex). Pernicious anemia occurs due
Avoidmilk,sweets,orsugars
Consumesmall,frequentmealsrather to a deficiency of the intrinsic
thanlargemeals. Prostaglandin factor normally secreted by
used to protect the stomach lining. the gastric mucosa.
Example:misoprostol (Cytotec)