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
Proton pump inhibitors
suppress the secretion of hydrochloric
acid into the lumen of the stomach.
Examples: omepra- zole (Prilosec),
esomeprazole (Nexium), lansoprazole
(Prevacid), dexlansoprazole (Kapidex),
pantoprazole (Protonix), and rabeprazole.
Management
Drinkalcoholinmoderation.
Stopsmokinganduseoftobacco
products.
Usestressmanagementtechniques.
AvoidNSAIDSasindicated.
Limitcaffeinecontainingbeverage
Lyingdownafteramealslowsthe
movementoffoodwithintheintestines.
Limittheamountoffluidingestedatone
time.
Eliminateliquidswithmeals,for1hr
priorto,andfollowingameal.
Consumeahighprotein,highfat,low
fiber,andlowtomoderatecarbohydrate
diet.
Avoidmilk,sweets,orsugars
Consumesmall,frequentmealsrather
thanlargemeals.
Medical Treatment
Signs & Symptoms
Antibiotcs
chemical that is able to inhibit the
growth of specified bacteria or cause the
death of susceptible bacteria.
Examples: metronidazole (Flagyl)or
amoxicillin (Amoxil) and
clarithromycin (Biaxin)
Histamine 2 Antagonist
block the release of hydrochloric acid in
response to gastrin.
Examples: cimetidine (Tagamet),
ranitidine (Zantac), famotidine (Pepcid),
and nizatidine (Axid). Complications
When peptic ulcers perforate
Antacids
or bleed, it is an emergency
are a group of inorganic chemicals that
situation.
neutralize stomach acid. Dumping syndrome is a group
Examples: sodium bicarbonate (Bell-
of manifestations that occur
ans), calcium carbonate (Oystercal,
following eating. A shift of fluid
Tums, and others), magnesium salts
(Milk of Magnesia and others), to the abdomen is triggered by
aluminum salts (Amphojel and others), rapid gastric emptying or high-
and magaldrate (Riopan). carbohydrate ingestion
(Aciphex). Pernicious anemia occurs due
to a deficiency of the intrinsic
Prostaglandin factor normally secreted by
used to protect the stomach lining. the gastric mucosa.
Example:misoprostol (Cytotec)