Gitu, md, florida state university college of medicine family medicine. What is the pathogenesis of peptic ulcer disease pud. Peptic ulcer disease a chronic disease with cyclic flow and a tendency to progression, which is characterized by the formation of a defect in the lining of the stomach or duodenum due to the reduction of its security properties or increasing aggressiveness of gastric juice. The epithelial cells of the stomach and duodenum secrete mucus in response to irritation of. Objectives o definition and pathogenesis of peptic ulcer o morphology of peptic ulcer o complications 3. The reduction in peptic ulcer disease complications might be. Pathology of peptic ulcer is the property of its rightful owner. Also, a numbers of factors are implicated in the pathogenesis of gastric ulcer, among which major. Peptic ulcer disease causes, symptoms, diagnosis, treatment. Pathology of peptic ulcer with its introdution and types. Historically, our understanding of the pathophysiology of peptic ulcer disease focused on abnormalities in.
Pathophysiology of duodenal and gastric ulcer and gastric. Peptic ulcer disease is common condition throughout the world. Peptic ulcer disease pud is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. A dull or burning pain in the stomach is the most common symptom. Approximately 11%14% of men and 8%11% of women will develop peptic ulcer disease in their lifetime. Proton pump inhibitors and recurrent bleeding in peptic ulcer disease. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. Changes in surgical treatment of peptic ulcer disease within a veterans hospital in the 1970s and the 1980s. Maximal histalog test in control subjects and patients with peptic ulcer. Urea breath testing is one option for test of cure and should be per formed four to six weeks after completion of eradication therapy.
They newly began in around 53 million people in 2014. Diagnosis and treatment of peptic ulcer disease and h. Antrectomy including the ulcer with a billroth i anastomosis is the treatment of choice for an antral ulcer. Descriptive epidemiology, risk factors, management and prevention. Helicobacter pylori hp in patients with suspected peptic ulcer disease pud. Before the discovery of h pylori it was known that patients with duodenal ulcers secrete about twice as much acid as controls because they have twice as many parietal cells. A peptic ulcer is an ulcer that occurs in the stomach or the first segment of the duodenum, parts of the intestinal tract that are bathed by gastric juice. Jul 15, 2018 objectives o definition and pathogenesis of peptic ulcer o morphology of peptic ulcer o complications 3.
Erosion differs from an ulcer in being partial thickness mucosal defect. In this fundamental study it was shown for the first time that maximal acid output as induced by histalog considerably overlaps between healthy subjects and the wide spectrum of peptic ulcer disease. Peptic ulcer, lesion that occurs primarily in the mucous membrane of the stomach or duodenum the upper segment of the small intestine. Peptic ulcers are painful sores in the lining of the stomach, esophagus, or small intestine. An overview of history, pathogenesis and treatment of. Peptic ulcer disease usually occurs in the stomach and proximal duodenum. The epithelial cells of the stomach and duodenum secrete mucus in. Introduction peptic ulcer disease represents a serious medical problem.
Clinical features 6 complications 7 summary this presentation was. Ulcers can recur in the absence of successful h pylori eradication. Ulcers can also result from burns, electric burns, and frostbite. Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone. Definition ulcer is defined as disruption of the mucosal integrity of stomach andor. Peptic ulcer ireland pdf ppt case reports symptoms. Aetology aetology of peptic ulcer disease is multifactorial. The pathophysiological and pharmacological basis of peptic.
Peptic ulcer disease pud pathophysiology 1 peptic ulcer disease pud pathophysiology. Walsh, mdt recent advanccs have led to improved understanding of peptic ulcer pathophysiology. In united states alone around 4 million individuals are affected. The mucus coats the inside of the stomach to protect it from being damaged by acid and digestive enzymes. The occurrence of peptic ulcer disease is similar in men and women. Pathology, peptic ulcer disease flashcards quizlet. Peptic ulcer disease causes, symptoms, diagnosis, treatment, pathology. Pathophysiology of peptic ulcer disease springerlink. When these defense mechanisms are disrupted, for example, by the bacterium helicobacter pylori or aspirin, people may develop gastritis or peptic ulcer disease. People who take nsaids such as aspirin and ibuprofen longterm or are infected with the bacteria h.
Quizlet flashcards, activities and games help you improve your grades. The concept of acid in peptic ulcer disease, which was the basis of treatment of peptic ulcer was revolutionized by the discovery of h 2receptor antagonists, that led to the principle of acid suppression therapy for duodenal ulcer which followed decades of. Despite the constant attack on the gastroduodenal mucosa by noxious agents acid, pepsin, bile acids, pancreatic enzymes, drugs, and bacteria, integrity is maintained by a system that provides mucosal defense and repair. Peptic ulcers are present in around 4% of the population. Nsai, aspirin, cortisone and cytotoxic drugs cigarette smoking. The pathogenesis of peptic ulcer disease may be considered as a combination scenario involving an imbalance between defensive factors mucusbicarbonate layer, prostaglandins, cellular regeneration, mucosal blood flow and aggravating factors hydrochloric acid, pepsin, ethanol, bile salts, drugs. Heterogeneity is the most important consideration in the pathophysiology of peptic ulcer disease. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine duodenum. The mortality rate for peptic ulcer disease is approximately one death per 10,000 cases. Parasuraman faculty of pharmacy, aimst university, malaysia.
Esophageal ulcer open sores or lesions in the lining of esophagus mostly occur in the lower end of esophagus causes associated with bad case of chronic gastro esophageal reflux disease or gerd. Burning sensation and occurs after mealsclassically, shortly after meals with gastric ulcer and 23 hours afterward with duodenal ulcer. It is in this group of peptic ulcers where improving local defense prop erties form a most attractive new approach to treatment. The bicarbonate within and under the mucus helps neutralize stomach acid. If you continue browsing the site, you agree to the use of cookies on this website.
Jul 17, 2012 lecture on the pathophysiology of peptic ulcer disease, including an introduction to the physiology of acid production and mucosal barrier defences in the st. Definition ulcer is defined as disruption of the mucosal integrity of stomach andor duodenum leading to a local defect or excavation due to active inflammation. Ulcers located near the esophagogastric junction require subtotal gastrectomy with a rouxeny esophagogastrojejunostomy csendes procedure. Treatment nearly all peptic ulcers will be treated with a proton pump inhibitor ppi like omeprazole, lansoprazole, pantoprazole, rabeprazole. Pathology, peptic ulcer disease study guide by dtyrells includes 56 questions covering vocabulary, terms and more. The second main symptom of gastrointestinal pathology is bleeding. Mucosal injury due to helicobacter pylori infection, nsaid use, zollingerellison syndrome multiple peptic ulcerations in stomach, duodenum and jejunum due to excess gastrin secretion by a tumor, ischemia, bile pancreatic juice reflux alcohol, smoking, copd and corticosteroids use may exacerbate peptic ulcer disease and impair healing. Oct 27, 2001 hypersecretion in duodenal ulcer disease. Mechanism of action, pharmacology, and side effects view in chinese approach to refractory peptic ulcer disease view in chinese association between helicobacter pylori infection and duodenal ulcer view in chinese cox2 inhibitors and gastroduodenal toxicity. Proton pump inhibitors ppis must be stopped for at least two weeks before the test, and accuracy is lower in patients who have had distal gastrectomy. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves.
Peptic ulcer disease symptoms, treatment, pathophysiology. Acute ulcers and erosions present clinically with gastrointestinal bleeding or perforation. Jan 14, 2014 aetology aetology of peptic ulcer disease is multifactorial. The upper git which includes the mouth, oesophagus and stomach. If so, share your ppt presentation slides online with. Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine.
Peptic ulcer disease including both gastric and duodenal ulcer form a substantial part of patients seeking surgical opinion worldwide. Ppt pathology of peptic ulcer powerpoint presentation. A basic paradigm for ulcer disease is the imbalance between the digestive activity of acid and pepsin and the protective mechanisms in place to resist mucosal digestion. The stomach is distensible and on a free mesentery, therefore, the size, shape, and. The character of the blood can help identify the source. In this fundamental study it was shown for the first time that maximal acid output as induced by histalog considerably overlaps between healthy subjects and. Historically, our understanding of the pathophysiology of peptic ulcer disease focused on abnormalities in the secretion of gastric acid and pepsin, and on. Infection with the bacteria helicobacter pylori occurs in 80 to 95% of patients with peptic ulcer disease. Lecture on the pathophysiology of peptic ulcer disease, including an introduction to the physiology of acid production and mucosal barrier defences in the st. Peptic ulcers can be caused by a bacteria helicobacter pylori h pylori. The gastrointestinal tract git, alimentary tract, gut it consists of an irregular tube about 6 m long, extending from the mouth to the anus. Get a printable copy pdf file of the complete article 2.
Alcohol, smoking, copd and corticosteroids use may exacerbate peptic ulcer disease and impair healing hyperacidity present in minority of duodenal ulcers and only rarely in gastric ulcers h. Peptic ulcer disease is when a defect develops in the mucous. Get yourself tested, because it is possible you might be suffering from peptic ulcer disease. Peptic ulcer is a break like a sore in the lining of the stomach or the upper part of the small intestine 1, with a diameter of at least 0. Peptic ulcer disease peptic ulcer disease appears to be a heterogeneous group of disorders having in common a hole in the gastroduodenal mucosa in the presence of gastric acid, but differing in the pathophysiology of ulcer ation.
Pathology, june, 1987 in philadelphia, pennsylvania. Peptic ulcer disease epigastric pain is the most common symptom of both gastric and duodenal ulcers. Introduction to gastritis and peptic ulcer disease. Ulcers are caused by an infection of a bacterium known as helicobacter pylori or h. Duodenal ulcer the peptic ulcer having a sore on the upper part of small intestine causes h.
A free powerpoint ppt presentation displayed as a flash slide show on id. In patients with nsaidassociated peptic ulcers, discontinuation of nsaids is paramount, if it is clinically feasible. The predominant causes in the united states are infection with helicobacter pylori and use of nonsteroidal anti. Pdf a peptic ulcer is a sore on the lining of the stomach or duodenum. Ppt peptic ulcer disease pud pathophysiology powerpoint. The reduction in peptic ulcer disease complications might be associated with the widespread use of anti. Peptic ulcer disease pud is a sore on the lining of the duodenum or stomach which occurs when the presence of some aggressive factors overwhelm that of the protective factors mucin secretion. Robin warren for their discovery of the bacterium helicobacter pylori and its role in gastritis and peptic ulcer disease. Pdf management of nsaidassociated peptic ulcer disease. Upper gi endoscopy is the preferred diagnostic test endoscopy visualize the ulcer. When an ulcer of the skin does not heal or is hard. An esophageal ulcer occurs in the lower part of your esophagus. It is the presence of ulcerations in gastrointestinal tract, which is characterized by being acidic, extremely painful. Clinical study of peptic ulcer disease allied academies.
Peptic ulcers are defects in the gastric or duodenal mucosa that extend through the muscularis mucosa. Peptic ulcer disease online medical video lecturio. Patients with gastric ulcer and those with functional dyspepsia have normal acid output and parietal cell count. A peptic ulcer stomach ulcer is a sore on the lining of your stomach or duodenum. Interestingly in 2005 a nobel prize was awarded to barry j. Interestingly, those at the highest risk of contracting peptic ulcer disease are those. Peptic ulcers are open sores that develop on the inside lining of your esophagus, stomach and the upper portion of your small intestine. Acute ulcer ulcus acutum smooth nonelevated borders and smooth base major bleeding into upper git chronic ulcer ulcus chronicum rushed and elevated boders, inflammation with hypertrophic and fibrotic proliferation is present the most frequent form of ulcer disease peptic ulcer disease classification. This teachable moment examines the case of a man in his 70s who presented to the emergency department 2 weeks after discontinuation of proton pump inhibitors ppis to caution against abrupt ppi discontinuation in patients with multiple risk factors for peptic ulcer disease. Clinical study of peptic ulcer disease peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine, called the duodenum.
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