Pdf pathogenesis and therapy of gastric and duodenal ulcer. In gastric ulcers, there is blood when the patient vomits called hematemesis. Diagnosis and treatment of peptic ulcer disease and h. This protocol may be used by general practitioners, family doctors, and nurses. Introduction peptic ulcer disease represents a serious medical problem. The diagnosis of a perforated duodenal ulcer in a rygp patient can be challenging, and there is variability in the surgical treatment, especially when it comes to the possible role of removing the gastric remnant. Gastritis and peptic ulcer disease pud affect up to 50% of adults in westernized countries. Mar 24, 2017 diet for duodenal ulcer includes eating small meals as this plan is effective to prevent discomfort for individuals suffering from ulcers. Diagnosis and management of perforated duodenal ulcers. Mar 23, 2017 the major cause for the formation of duodenal ulcer is the bacteria known as helicobacter pylori a. Protocol for diagnosis and treatment of peptic ulcer in adults. We present two cases of a perforated duodenal ulcer following rouxeny gastric bypass and discuss the management of these patients. A crater ulcer in the lining of the beginning of the small intestine duodenum. In duodenal ulcers, pain occurs 34 hours after eating.
Causes and incidence the precise etiologic mechanisms of peptic ulcer formation are unclear. Gastric ulcer case presentation 44 yo female intractable peptic ulcer disease x 2yrs treated for h. A peptic ulcer in the stomach is called a gastric ulcer. Foods that are more irritating to the stomach are often avoided for peptic ulcers. In gastric ulcers, pain occurs 12 hours after eating. Gastroduodenal peptic ulcer perforation article pdf available in east african medical journal 863. Duodenal ulcers if you have been treated for a duodenal ulcer without complications, you most likely will not need any followup monitoring of the ulcer itself. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. Gastritis and peptic ulcer disease nutrition guide for. Unlike duodenal ulcer, pain caused by gastric ulcer cannot be relieved by eating food.
History of helicobacter pylori, duodenal ulcer, gastric ulcer. In patients with peptic ulcer disease, helicobacter pylori should be eradicated to assist in healing and to reduce the risk of gastric and duodenal ulcer recurrence. This bacteria causes contamination in the body and due to which the duodenal ulcer takes birth. Both gastric and duodenal ulcers relate to the corrosive action of pepsin and hydrochloric acid on the mucosa of the upper gastrointestinal tract. If the ulcer was large or led to other problems such as bleeding or perforation, or if your symptoms persist or recur, your healthcare provider may recommend a repeat endoscopy to. Bleeding may be controlled at endoscopy but in some cases needs surgery when unsuccessful. They affect different parts of the digestive tract, but both can cause pain and discomfort, and serious complications if they are left untreated. Ulcers, gastric and duodenal article about ulcers, gastric. To further study the effects of stress on ulcer risk, the researchers analyzed historical data from 76 patients who lacked a history of gastric and duodenal ulcers in 1982, but by 1994 had developed distinct breaches in the mucosa that were confirmed by endoscopy or contrast radiology. Gastric and duodenal ulcers health funders association. Jan 11, 2012 this entry was posted in anatomy and tagged biliary duct, coffeeground vomiting, gastric ulcers, gastroduodenal artery ulcer, gastrointestinal bleeding, hemorrhage, hepatic artery, lifethreatening hemorrhage, liver, neck of the gallbladder, posterior wall of the duodenal bulb, proximal part of the duodenum, pylorus, vena pora.
Difference between a duodenal ulcer and gastric ulcer. Gastric and duodenal ulcer peptic ulcer stomach free 30. A duodenal or peptic ulcer is an open sore in the intestine wall. The duodenal ulcer is observed as single or multiple ulcer localized in duodenum only. Pmb definition guideline for gastric or intestinal ulcers.
Difference between gastric and duodenal ulcers hrf. Bleeding gus should be resected even just a local resection or at least biopsied for the possibility of neoplasms. Genetic factors play a role in the pathogenesis of ulcer disease. Define peptic ulcer and identify the risk factors for its formation. Approximately 10% of the us population has evidence of a duodenal ulcer at some time. Gastric and duodenal ulcers in adults clinical guidelines. In case of bleeding duodenal ulcer dus it might be needed to perform a duodenotomy and open across d1 and pylorus, longitudinally. Describe the pathophysiology and clinical manifestations of peptic ulcer. The most discriminating symptom of pain awakening the patient from sleep between 123 a.
Bland diet peptic ulcer the diet for peptic ulcers should be wellbalanced while eliminating foods that cause you repeated distress. If a diagnosis of ulcer is probable, and the patient has frequent attacks requiring repeated treatment with antiulcer drugs or, in cases of complicated ulcers perforation or gastrointestinal bleeding treatment to eradicate h. As in the us, duodenal ulcer disease prevalence is linked to h pylori infection. Management of perforated gastric and duodenal ulcers. The lifetime prevalence of developing ulcer disease in firstdegree relatives of ulcer patients is about three times greater than the general population. In western developed countries, the ratio of duodenal ulcer to gastric ulcer is reversed, with a higher incidence of duodenal ulcers. Gastric versus duodenal ulcer although there is much overlap, symptoms of a gastric ulcer may be different than those of a duodenal ulcer.
The most common complications are perforation and bleeding. The bacterium is a known cause of gastric and duodenal ulcers5 and is a risk factor for. Recent evidence suggests that abnormalities in gastrin release and action may be influenced by participation of somatostatin. Peptic ulcers are deeper erosions and ulcerations that extend through the muscularis layer of the gastric or duodenal mucosa. However, recent research points to infection by helicobacter pylori bacteria as the major factor in ulcer. A 4 to 8week course of acidsuppressing medication will allow the ulcer to heal.
Duodenal pain small bowel location, causes, treatment. Duodenal ulcers classically present earlier than gastric ulcers, by around 20 years. Duodenal pain refers to any pain that arises from the duodenum. An esophageal ulcer occurs in the lower part of your esophagus. It is highly sensitive for the diagnosis of gastric and duodenal ulcers, allows for biopsies and cytologic brushings in the setting of a gastric ulcer to differentiate a benign ulcer from a malignant lesion, and allows for the detection of h pylori infection. Knowledge of the mechanisms that lead to ulcer formation or to gastric cancer in. Management of patients with gastric and duodenal disorder. This is the first part of the small intestine that starts where the stomach ends and continues for about 25 to 38 centimeters about 10 to 15 inches until the jejunum which is the second part of the small intestine. Keeping a food journal as a part of duodenal ulcer diet plan helps individuals to understand the type of food he or she should take in order to stay fit and healthy. Therefore, antibiotics would be the best treatment. In addition, a oneweek course of two antibiotics plus an acidsuppressing medicine will usually clear the h. What are the risk factors for equine gastric ulcer syndrome.
Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone. Ulcer formation is caused by infection with helicobacter pylori. Surgical management of bleeding gastric and duodenal ulcer. Of those infected with h pylori, the lifetime prevalence is approximately 20%. The global incidence of peptic ulcer disease and its complications at the turn of the 21st century. 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. This entry was posted in anatomy and tagged biliary duct, coffeeground vomiting, gastric ulcers, gastroduodenal artery ulcer, gastrointestinal bleeding, hemorrhage, hepatic artery, lifethreatening hemorrhage, liver, neck of the gallbladder, posterior wall of the duodenal bulb, proximal part of the duodenum, pylorus, vena pora. A peptic ulcer on the inside of the stomach lining is a gastric. Eradication heals most duodenal ulcers and greatly diminishes the risk of recurrent bleeding. May 01, 2010 gastric versus duodenal ulcer although there is much overlap, symptoms of a gastric ulcer may be different than those of a duodenal ulcer. Diet for duodenal ulcer includes eating small meals as this plan is effective to prevent discomfort for individuals suffering from ulcers. Duodenal ulcer classic symptoms of a duodenal ulcer include burning, gnawing, aching, or hungerlike pain, primarily in the upper middle region of the abdomen below the breastbone the epigastric. Gastritis is a superficial erosion and inflammation of the gastric mucosa.
Once the acute phase has passed, administer for 10 days. Duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori. Patients suffering from gastric ulcer are placed on special diets and are advised to avoid foods that are creamy or milky e. Gastric and duodenal ulcers were classified as an independent nosologic entity in 1829 by the french physician j.
It could take a good time of 4 to 8 weeks for this ulcer to heal if we use corrosive solutions. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Clinical study of peptic ulcer disease allied academies. The polypeptide hormone, gastrin does, however, appear to play subtle and multiple roles in enhancement of gastric acid secretion in duodenal ulcer.
Perforated duodenal ulcer article in obesity surgery 175. Gastric and duodenal ulcers are both types of peptic ulcers. Knowledge of the mechanisms that lead to ulcer formation or to gastric. H pylori can elevate acid secretion in people who develop duodenal ulcers, decrease acid through gastric atrophy in those who develop gastric ulcers or cancer. Individuals currently experiencing ulcers should be encouraged to avoid foods that exacerbate symptoms and. In this article, we shall look at the clinical features, investigations and management of peptic ulcer disease.
Start studying comparison of duodenal ulcer and gastric ulcer. A duodenal ulcer is usually caused by an infection with a germ bacterium called helicobacter pylori h. May 14, 2014 duodenal ulcer appeared to burst on the scene in the late 19 th and early 20 th century. However duodenal ulcers that present as an emergency to hospital with either bleeding or perforation do require aggressive treatment. Comparison of duodenal ulcer and gastric ulcer flashcards. A gp will almost certainly suspect an ulcer when presented with the symptoms, but will confirm it with a gastroscope where a flexible camera is passed down the throat. Pdf despite the decreasing frequency of helicobacter pyloriinduced peptic ulcers, peptic ulcer disease remains a major clinical problem. Gastric and duodenal ulcers article about gastric and.
Pathophysiology of duodenal and gastric ulcer and gastric. Mar 22, 2018 the acidic gastric juice can trigger the formation of ulcer within the mucosa of esophagus, stomach and duodenum. Ulcer a circumscribed excavation of the gastric or duodenal mucosal wall that penetrates the muscularis mucosae and exposes it to acid and pepsin. Overall, the incidence of duodenal ulcers has been decreasing over the past 34 decades. However, these same symptoms are also seen in of patients with nonulcer dyspepsia. Though nsaid use can mediate peptic ulcer disease, nsaid use is not the most common cause of peptic ulcer disease. Oct 27, 2001 duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori. The ulcer is known as peptic ulcer when gastric acidic juice causes ulcers within mucosa of stomach, esophagus and duodenum. Gastric and duodenal ulcers are types of peptic ulcer. Diagnosis and treatment of perforated or bleeding peptic. Ulcers, gastric and duodenal also peptic ulcers, a chronic disease characterized by the formation of ulcerations in the stomach or duodenal wall. Upper gastrointestinal gi endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease. In a duodenal ulcer, there is bleeding in the stool called melena.
Stomach gastric and small intestine duodenal ulcers are two types of peptic ulcers. Mass eradication of h pylori is impractical because of the cost and the danger of generating antibiotic resistance, so we need to know how to target prophylaxis. Duodenal ulcer appeared to burst on the scene in the late 19 th and early 20 th century. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine duodenum. Exercise and regular competition have been shown to be major risk factors for the development of gastric ulcers in the horse.
The acidic gastric juice can trigger the formation of ulcer within the mucosa of esophagus, stomach and duodenum. A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. However, these same symptoms are also seen in of patients with non ulcer dyspepsia. Mar 25, 2020 upper gastrointestinal gi endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease.