Peptic ulcers, it's diagnosis, treatment

This presentation contains detailed information about Peptic ulcers, it's causes, it's treatment, it's diagnosis and management and it's better presentation made by me for the help of medical students. Readers will cover all the things related to Peptic ulcer.

A peptic ulcer is a sore or lesion that forms in the lining of the stomach, the first part of the small intestine (duodenum), or the lower esophagus. It develops when the protective mucous lining of the digestive tract is eroded, allowing digestive acids and enzymes to damage the underlying tissue.

Symptoms of peptic ulcers can vary but often include abdominal pain, nausea, vomiting, bloating, heartburn, loss of appetite, unintended weight loss, dark or tarry stools (indicating gastrointestinal bleeding), and vomiting blood.

Diagnosis typically involves a combination of medical history review, physical examination, endoscopy (using a flexible tube with a camera to visualize the digestive tract), biopsy (to detect H. pylori infection or rule out other conditions), laboratory tests (to detect H. pylori antibodies or antigens), and imaging studies.

Treatment aims to relieve symptoms, promote ulcer healing, prevent complications, and address underlying causes. This may involve medications such as proton pump inhibitors (PPIs) to reduce gastric acid production, histamine-2 (H2) receptor antagonists to block acid secretion, and antibiotics to eradicate H. pylori infection. Lifestyle modifications such as avoiding NSAIDs, alcohol, and smoking are also recommended.

In severe cases or when complications occur, surgical intervention may be necessary to repair the ulcer and address associated damage. Early diagnosis and appropriate treatment are crucial for managing peptic ulcers effectively and reducing the risk of complications. Individuals experiencing symptoms suggestive of peptic ulcers should seek medical attention promptly for evaluation and management.

I will recommend this presentation to all of medical students who are currently studying in any field.

Overall, early diagnosis and appropriate treatment are essential for managing peptic ulcers effectively and reducing the risk of complications. It's important for individuals experiencing symptoms suggestive of peptic ulcers to seek medical attention promptly for proper evaluation and management.

Treatment typically involves medications to reduce stomach acid production, antibiotics to eradicate H. pylori infection if present, and lifestyle changes such as avoiding irritants like NSAIDs and alcohol. In severe cases, surgery may be necessary to repair complications such as perforation or bleeding.

The major causes of peptic ulcers include infection with Helicobacter pylori bacteria, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, smoking, and genetic predisposition. These factors can disrupt the protective mucosal lining of the gastrointestinal tract, leading to ulcer formation.

1. Peptic ulcer Disease Assigned by: Dr Ayaz Ali Unar Presented by: Faraz Hussain  0 5 Saifullah  28 M. Usama  19 Imam bux  42 Imtiaz Ali  12

2. Content Introduction Pathophysiology Types of ulcer Diagnosis Prevention Management / Treatment Reference

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4. Introduction of peptic ulcer Peptic ulcer is Breach (break ) in the mucosa that extends through the muscularis mucosae into the submucosa or deeper due to gastric HCL and Pepsin Erosions : A breach in the epithelium of the mucosa only ( superficial ). Peptic ulcer healing takes much more time Erosions heal within days

5. Complications Blockage of stomach (frequently vomiting due to undigestion) Bleeding Perforation ( formation of hole )

6. Signs and symptoms 1) Abdominal pain 2) Nausea and vomiting 3) Hematemesis 4) Heartburn A gastric ulcer would give  epigastric pain during the meal , associated with nausea and vomiting, as gastric acid production is increased as food enters the stomach. Pain in duodenal ulcers would be aggravated by hunger and relieved by a meal and is associated with night pain .

7. Pathophysiology Peptic ulcer results from increased damaging agents and decreased defensive mechanisms (Mucosal defenses) Mucosal defenses: 1) Surface mucus layer 2) NAH2CO3 3) Epithelial cells

8. Damaging agents : 1) H. Pylori 2) HCL 3) NSAIDs 4) Pepsin 5) Major trauma

9. Types of Ulcer on basis of location 1) Gastric ulcer also called Stomach ulcer Breach on inside of stomach Causes : Helicobacter pylori, NSAIDS 2) Duodenal ulcer also called intestinal ulcer Cause : Breach on upper part of small intestine Causes : H. Pylori, damaged mucosal layer 3) Esophageal ulcer : due to reflux of HCL

10. Diagnosis 1- Esophagogastroduodenoscopy (EGD): a form of endoscopy, also known as a  gastroscopy . By direct visual identification , the location and severity of an ulcer can be described by EGD 2- Upper gastrointestinal series UGS : X-ray that visualize upper GIT

11. Endoscopic appearance Macroscopic appearance

12. 3- Urea breath test : involves Use of radioactive carbon to detect H.pylori In this test, patient asked to drink liquid which contains carbon, after 1 hour, patients will be asked to breath in sealed bag, if breath sample contains radioactive carbon, it indicates presence of H.pylori

13. Prevention Prevention of peptic ulcer disease for those who are taking NSAIDs (with low cardiovascular risk) can be achieved by adding a  proton pump inhibitor (PPI), an H2 antagonist, or misoprostol.

14. Treatment H. Pylori induced ulcer : Once the diagnosis of H. pylori is confirmed, the first-line treatment would be a triple regimen in which pantoprazole and clarithromycin are combined with either amoxicillin or metronidazole. This treatment regimen can be given for 7–14 days .

15. NSAIDs induced ulcer : NSAID-associated ulcers heal in 6 to 8 weeks provided the NSAIDs are withdrawn with the introduction of proton pump inhibitors. After H. pylori is eradicated, there is low risk of recurrent ulcer bleeding when NSAIDs are resumed.

16. Management 1) lifestyle modification 2) NSAIDS Cessation 3) Alcohol Cessation 4) Stress reduction 5) Antacids  neutralization of acid and prevention of pepsin formation 6) PGE2 analogs prevent HCL secretion 7) Mucosal barriers form protective layer

17. References Medical Wikipedia Robbins basic Pathology Underwood’s Pathology