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GASTROINTESTINAL

DISEASES

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PEPTIC ULCER DISEASE

 CHRONIC DUODENAL ULCER

  CHRONIC BENIGN GASTRIC ULCER

•March 10, 2016 •Total slide. 12 •2

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!e"tic Ulcer Disease #!UD$

• %hat is it&• Gro'" o( chronic )isor)ers characteri*e) +y 'lceratin, m'cosal lesions in

'""er GI tract

• chronic in-ammatory con)ition

• common (orms are )'o)enal an) ,astric 'lceration

• %here )oes it occ'r&• Stomach. )'o)en'm

• %hat ca'ses !UD&• H. pylori or )r', in)'ce) #most commonly +y chronic NSAID 'se$

•March 10, 2016 •Total slide. 126 •3

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Dr',s that can ca'se !UD

• methotre/ate

• cyclo"hos"hami)e

• a*athio"rine

• erythromycin

• iron• corticosterio)s

• "otassi'm chlori)e

• NSAIDS

•March 10, 2016 •Total slide. 126 •4

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Si,ns an) Sym"toms o( !UD

• Can +e sym"tomatic• anore/ia. na'sea. 0omitin,. +elchin,. +loatin,.

heart+'rn. e"i,astric "ain #"ain in the '""er a+)omen$• aaene) at ni,ht #'s'3 aro'n) 4am.$

• )'o)enal 'lcers• e"i,astric "ain. ten)erness. +'rnin,. achin, +eteen /i"hoi)

"rocess an) +elly +'tton

• relie0e) ith (oo) intae or antaci)s

• ,astric 'lcer

• )i5'se "ain o0er mi)e"i,astri'm #mi)stomach$• orsene) +y (oo)

•March 10, 2016 •Total slide. 126 •5

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!atholo,y o( !e"tic Ulcer

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Normal Stomach

•March 10, 2016 •Total slide. 126 •8

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Eso"ha,'s 7 Stomach Normal

•March 10, 2016 •Total slide. 126 •9

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De8nition9

• Ulceration #+reach in m'cosa$ )'e to aci) 7 "e"sinattac : "e"tic 'lcer3

• Dee"er than ;'st m'cosa

• Sin,le. "'nche) o't. clean +ase

•March 10, 2016 •Total slide. 126 •10

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Etiolo,y9

• Helico+acter "ylori in(ection3

• Hy"eraci)ity 6 e,3 *ollin,erellison3

• Dr',s 6 anti6in-ammatory#NSAIDs$ 7 Corticostroi)s3

• Ci,arette smoin,. Alcohol.

• Ra"i) ,astric em"tyin,

• !ersonality an) stress

•March 10, 2016 •Total slide. 126 •11

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H3 !ylori or,anisms6 sil0er st3

•March 10, 2016 •Total slide. 126 •12

Cli i l i h i G i i l i

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!atho,enesis9

• Helico+acter "ylori in(ection

• Coloni*ation o( ,astric m'co's

• Urease ammonia ne'trali*ation o( aci)  Re+o'n) aci) "ro)'ction3

• !rotease :

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Normal

Increase) Attac  Hy"eraci)ity

%ea )e(ense  Helico+acter "ylori  Stress. )r',s. smoin,

•March 10, 2016 •Total slide. 126 •14

Etiology of PUD

Cli i l Bi h i t G t i t ti l Di

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Helico+acter "ylori9

• $

• 1=> o( men. ?> omen )e0elo" !UD

• !ositi0e in @=61==> o( !UD "atients3

• H3"ylori relate) )isor)ers9• Chronic ,astritis : =>• !e"tic 'lcer )isease : 61==>• Gastric carcinoma : @=>• Gastric lym"homa

• Re-'/ Oeso"ha,itis3• Non 'lcer )ys"e"sia

•March 10, 2016 •Total slide. 126 •15

Cli i l Bi h i t G t i t ti l Di

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!e"tic Ulcer

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Gastric "e"tic 'lcer

•March 10, 2016 •Total slide. 126 •18

Clinical Biochemistry Gastrointestinal Disease

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Re(erences

• 3%ii"e)ia3or,

• 3++corl)3com

• 3enotes3com

•March 10, 2016 •Total slide. 12 •19

http://www.wikipedia.org/http://www.bbcworld.com/http://www.enotes.com/http://www.enotes.com/http://www.bbcworld.com/http://www.wikipedia.org/