SlideShare a Scribd company logo

Peptic Ulcer Disease.Ppt.Fmdrl

•Download as PPT, PDF•
•
M
MedicineAndHealthUSA

This document discusses peptic ulcer disease (PUD), including risk factors, pathophysiology, diagnosis, and treatment. Some key points: - H. pylori infection and NSAID use are the leading causes of PUD. H. pylori infection is present in 60% of Americans over age 60. - Diagnosis involves testing for H. pylori (stool antigen, urea breath, serology), and endoscopy if high risk or symptoms persist after treatment. - Treatment for H. pylori-associated PUD is triple therapy (PPI plus two antibiotics) for 14 days. NSAID-associated PUD is treated with PPIs and prostag

Health & Medicine
1 of 56
Peptic Ulcer Disease Ramona Carter-Burdine M.D. UTMB Galveston, Tx
Learning Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object]
Disease Prevalence ,[object Object],[object Object],[object Object],[object Object],[object Object]
Definition ,[object Object],[object Object]
Differentiating gastric from peptic ulcer disease ,[object Object],[object Object],[object Object]
Case Presentation ,[object Object],[object Object],[object Object],[object Object]
Initial Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mr. Jones HPI ,[object Object],[object Object]
Signs and Symptoms of PUD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Pearls ,[object Object],[object Object]
Mr Jones History ,[object Object],[object Object],[object Object],[object Object]
Common Risk Factors for Gastric Mucosal Disruption ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology ,[object Object]
NSAIDs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Individual NSAID Risk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History of Ulcer Treatment ,[object Object],[object Object],[object Object]
History of Ulcer Treatment Cont’d ,[object Object],[object Object],[object Object],[object Object]
Discovery of Helicobacter pylori ,[object Object],“Robin Warren and Barry Marshall's work on ulcers was pioneering” Story from BBC NEWS: http://news.bbc.co.uk/go/pr/fr/-/2/hi/asia-pacific/4307826.stm Published: 2005/10/04 10:39:09 GMT © BBC MMVII
H. pylori ,[object Object],[object Object],[object Object],[object Object],[object Object]
H. pylori ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Differentiating between H. pylori and NSAID-induced ulcer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Disease Conditions Associated with PUD ,[object Object],[object Object]
Mr. Jones Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Exam Findings ,[object Object],[object Object],[object Object],[object Object],[object Object]
If Mr. Jones Hemoccult is Positive ,[object Object],[object Object],[object Object]
Lab Studies to Evaluate PUD ,[object Object],[object Object],[object Object],[object Object],[object Object]
Principles in Selecting H. pylori Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H. Pylori Serology Antibody Test ,[object Object],[object Object],[object Object]
When is a Serology Test Useful? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H. Pylori Stool Antigen (HpSa) Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Urea Breath Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breath Test Compared to HpSa ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging Studies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Endoscopy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rapid Urease Test and Histopathology ,[object Object],[object Object],[object Object]
Mr. Jones Prior Ulcer History ,[object Object],[object Object]
Answer ,[object Object],[object Object],[object Object]
Moving on to Treatment Options……….
Over The Counter Remedies ,[object Object],[object Object],[object Object],[object Object]
Over the Counter Remedies cont’d ,[object Object],[object Object]
H2-Blockers ,[object Object],[object Object],[object Object]
Side Effects of Cimetidine/Tagamet ® ,[object Object],[object Object],[object Object],[object Object]
Proton Pump Inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Other Pharmacotherapy Agents ,[object Object],[object Object]
H. Pylori Triple Therapy Treatment ,[object Object],[object Object],[object Object],[object Object]
H Pylori Treatment http://www.drugdigest.org/DD/Comparison/NewComparison/0,10621,550540-21,00.html Cure Rate Side Effect Rating 81-92% low-medium Prevpak 80-85% medium-high Helidac + H2 blocker Combination Products 80-90% medium Amoxicillin + Metronidazole + PPI 80-90% medium-low Amoxicillin + Clarithromycin + PPI 80-90% medium Clarithromycin + Metronidazole + PPI Three Drug Regimens
H. Pylori Therapy cont’d ,[object Object],[object Object],[object Object]
PUD Complications ,[object Object],[object Object],[object Object],[object Object]
Initial Treatment Plan in the Absence of High Risk Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Final Recommendations ,[object Object],[object Object],[object Object],[object Object]
Medical Legal Pitfalls ,[object Object],[object Object],[object Object],[object Object],[object Object]
Alternate Scenarios of Mr. Jones Case ,[object Object],[object Object]
Alternate Scenarios to Mr. Jones Case ,[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References cont’d ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

peptic ulcer disease.PPT
peptic ulcer disease.PPTpeptic ulcer disease.PPT
peptic ulcer disease.PPTheba abou diab
 
introduction of lower GI disorders
introduction of lower GI disordersintroduction of lower GI disorders
introduction of lower GI disordersneha maurya
 
Peptic ulcer disease Mallappa Shalavadi,,
Peptic ulcer disease Mallappa Shalavadi,,Peptic ulcer disease Mallappa Shalavadi,,
Peptic ulcer disease Mallappa Shalavadi,,Dr. Mallappa Shalavadi
 
Dyspepsia
DyspepsiaDyspepsia
DyspepsiaMohammed Musa
 
Intestinal obstruction
Intestinal obstructionIntestinal obstruction
Intestinal obstructionmeducationdotnet
 
Peptic ulcer
Peptic ulcerPeptic ulcer
Peptic ulcerSubramani Parasuraman
 
Constipation
Constipation Constipation
Constipation Bharat Pokhrel
 
Irritable bowel syndrome
Irritable bowel syndromeIrritable bowel syndrome
Irritable bowel syndromewisam alsaedi
 

Recommended

peptic ulcer disease.PPT
peptic ulcer disease.PPTpeptic ulcer disease.PPT
peptic ulcer disease.PPTheba abou diab
 
introduction of lower GI disorders
introduction of lower GI disordersintroduction of lower GI disorders
introduction of lower GI disordersneha maurya
 
Peptic ulcer disease Mallappa Shalavadi,,
Peptic ulcer disease Mallappa Shalavadi,,Peptic ulcer disease Mallappa Shalavadi,,
Peptic ulcer disease Mallappa Shalavadi,,Dr. Mallappa Shalavadi
 
Dyspepsia
DyspepsiaDyspepsia
DyspepsiaMohammed Musa
 
Intestinal obstruction
Intestinal obstructionIntestinal obstruction
Intestinal obstructionmeducationdotnet
 
Peptic ulcer
Peptic ulcerPeptic ulcer
Peptic ulcerSubramani Parasuraman
 
Constipation
Constipation Constipation
Constipation Bharat Pokhrel
 
Irritable bowel syndrome
Irritable bowel syndromeIrritable bowel syndrome
Irritable bowel syndromewisam alsaedi
 
Peptic ulcer
Peptic ulcerPeptic ulcer
Peptic ulcerAniedu Ifeanyichukwu
 
treatment of constipation
treatment of constipationtreatment of constipation
treatment of constipationVishnu Vardhan
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer diseaseBimel Kottarathil
 
Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Abhay Rajpoot
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer diseaseLala Gladson Ananda Robin
 
Achalasia
AchalasiaAchalasia
Achalasiafareedresidency
 
Gastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its managementGastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its managementDr. Ankit Gaur
 
Constipation
Constipation Constipation
Constipation RIPS-14
 
Gastritis
GastritisGastritis
GastritisNikhil Vaishnav
 
IBS
IBSIBS
IBSSrinivas Patnaik
 
Diarrhea ppt
Diarrhea pptDiarrhea ppt
Diarrhea pptKapil Dhingra
 
Gastritis
GastritisGastritis
Gastritisfitango
 
Peptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical PharmacyPeptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical PharmacyNowras Rahhal
 
Ulcerative Colitis
Ulcerative Colitis Ulcerative Colitis
Ulcerative Colitis MR. JAGDISH SAMBAD
 
Inflammatory Bowel Disease
Inflammatory Bowel DiseaseInflammatory Bowel Disease
Inflammatory Bowel DiseaseKirsha K S
 
Duodenal ulcer presentation
Duodenal ulcer presentationDuodenal ulcer presentation
Duodenal ulcer presentationRavindra Verma
 
Treatment of diarrhea
Treatment of diarrheaTreatment of diarrhea
Treatment of diarrheaVishnu Vardhan
 
Gastroenteritis
GastroenteritisGastroenteritis
GastroenteritisMedesun Healthcare Solutions LLC
 
Gastrointestinal Tract Diseases
Gastrointestinal Tract DiseasesGastrointestinal Tract Diseases
Gastrointestinal Tract DiseasesAndrea B.
 
Dyspepsia
DyspepsiaDyspepsia
DyspepsiaHamza AlGhamdi
 
Peptic ulcer, GERD; management
Peptic ulcer, GERD; managementPeptic ulcer, GERD; management
Peptic ulcer, GERD; managementDr. Rupendra Bharti
 
Pud letcture
Pud letcturePud letcture
Pud letcturetashebir
 

More Related Content

What's hot

treatment of constipation
treatment of constipationtreatment of constipation
treatment of constipationVishnu Vardhan
 
Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Abhay Rajpoot
 
Gastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its managementGastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its managementDr. Ankit Gaur
 
Constipation
Constipation Constipation
Constipation RIPS-14
 
Gastritis
GastritisGastritis
Gastritisfitango
 
Peptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical PharmacyPeptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical PharmacyNowras Rahhal
 
Inflammatory Bowel Disease
Inflammatory Bowel DiseaseInflammatory Bowel Disease
Inflammatory Bowel DiseaseKirsha K S
 
Duodenal ulcer presentation
Duodenal ulcer presentationDuodenal ulcer presentation
Duodenal ulcer presentationRavindra Verma
 
Gastrointestinal Tract Diseases
Gastrointestinal Tract DiseasesGastrointestinal Tract Diseases
Gastrointestinal Tract DiseasesAndrea B.
 

What's hot (20)

Peptic ulcer
Peptic ulcerPeptic ulcer
Peptic ulcer
 
treatment of constipation
treatment of constipationtreatment of constipation
treatment of constipation
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer disease
 
Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Ulcerative Colitis (UC)
Ulcerative Colitis (UC)
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer disease
 
Achalasia
AchalasiaAchalasia
Achalasia
 
Gastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its managementGastro esophageal Reflux Disease (GERD) and its management
Gastro esophageal Reflux Disease (GERD) and its management
 
Constipation
Constipation Constipation
Constipation
 
Gastritis
GastritisGastritis
Gastritis
 
IBS
IBSIBS
IBS
 
Diarrhea ppt
Diarrhea pptDiarrhea ppt
Diarrhea ppt
 
Gastritis
GastritisGastritis
Gastritis
 
Peptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical PharmacyPeptic Ulcer _ Clinical Pharmacy
Peptic Ulcer _ Clinical Pharmacy
 
Ulcerative Colitis
Ulcerative Colitis Ulcerative Colitis
Ulcerative Colitis
 
Inflammatory Bowel Disease
Inflammatory Bowel DiseaseInflammatory Bowel Disease
Inflammatory Bowel Disease
 
Duodenal ulcer presentation
Duodenal ulcer presentationDuodenal ulcer presentation
Duodenal ulcer presentation
 
Treatment of diarrhea
Treatment of diarrheaTreatment of diarrhea
Treatment of diarrhea
 
Gastroenteritis
GastroenteritisGastroenteritis
Gastroenteritis
 
Gastrointestinal Tract Diseases
Gastrointestinal Tract DiseasesGastrointestinal Tract Diseases
Gastrointestinal Tract Diseases
 
Dyspepsia
DyspepsiaDyspepsia
Dyspepsia
 

Similar to Peptic Ulcer Disease.Ppt.Fmdrl

Pud letcture
Pud letcturePud letcture
Pud letcturetashebir
 
Early diagnosis & treatment of most common gastrointestinal disease
Early diagnosis & treatment of most common gastrointestinal diseaseEarly diagnosis & treatment of most common gastrointestinal disease
Early diagnosis & treatment of most common gastrointestinal diseaseShaiket16
 
Peptic ulcer Disease
Peptic ulcer DiseasePeptic ulcer Disease
Peptic ulcer DiseaseMark Gokia
 
Git Bmj Dyspepsia Mangement.
Git Bmj Dyspepsia Mangement.Git Bmj Dyspepsia Mangement.
Git Bmj Dyspepsia Mangement.Shaikhani.
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer diseaseKavyaHB
 
Pud final 1
Pud final 1Pud final 1
Pud final 1alaaag
 
Peptic Ulcer Saint James School of Medicine
Peptic Ulcer Saint James School of Medicine Peptic Ulcer Saint James School of Medicine
Peptic Ulcer Saint James School of Medicine bimmerque
 
peptic ulcer disease
peptic ulcer diseasepeptic ulcer disease
peptic ulcer diseaseLih Yin Chong
 
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdf
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdfPeptic-Ulcer-Epidemiology-and-Social-Factor.pdf
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdfLeoTorres91
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer diseaseBasil Wilson
 
( Peptic ulcer disease ) .pptx
( Peptic ulcer disease ) .pptx ( Peptic ulcer disease ) .pptx
( Peptic ulcer disease ) .pptxAhad412190
 
Pud Gastritis Lecture[1]
Pud Gastritis Lecture[1]Pud Gastritis Lecture[1]
Pud Gastritis Lecture[1]Miami Dade
 

Similar to Peptic Ulcer Disease.Ppt.Fmdrl (20)

Peptic ulcer, GERD; management
Peptic ulcer, GERD; managementPeptic ulcer, GERD; management
Peptic ulcer, GERD; management
 
Pud letcture
Pud letcturePud letcture
Pud letcture
 
Peptic ulcer disease/ Epigastric pain
Peptic ulcer disease/ Epigastric painPeptic ulcer disease/ Epigastric pain
Peptic ulcer disease/ Epigastric pain
 
Early diagnosis & treatment of most common gastrointestinal disease
Early diagnosis & treatment of most common gastrointestinal diseaseEarly diagnosis & treatment of most common gastrointestinal disease
Early diagnosis & treatment of most common gastrointestinal disease
 
Esophagitis
Esophagitis Esophagitis
Esophagitis
 
Peptic ulcer Disease
Peptic ulcer DiseasePeptic ulcer Disease
Peptic ulcer Disease
 
A Case of Chronic Diarrhoea
A Case of Chronic DiarrhoeaA Case of Chronic Diarrhoea
A Case of Chronic Diarrhoea
 
Git Bmj Dyspepsia Mangement.
Git Bmj Dyspepsia Mangement.Git Bmj Dyspepsia Mangement.
Git Bmj Dyspepsia Mangement.
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer disease
 
Pud final 1
Pud final 1Pud final 1
Pud final 1
 
Peptic Ulcer Saint James School of Medicine
Peptic Ulcer Saint James School of Medicine Peptic Ulcer Saint James School of Medicine
Peptic Ulcer Saint James School of Medicine
 
peptic ulcer disease
peptic ulcer diseasepeptic ulcer disease
peptic ulcer disease
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer disease
 
PUD.pptx
PUD.pptxPUD.pptx
PUD.pptx
 
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdf
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdfPeptic-Ulcer-Epidemiology-and-Social-Factor.pdf
Peptic-Ulcer-Epidemiology-and-Social-Factor.pdf
 
Peptic ulcer disease
Peptic ulcer diseasePeptic ulcer disease
Peptic ulcer disease
 
18 peptic ulcer
18 peptic ulcer18 peptic ulcer
18 peptic ulcer
 
( Peptic ulcer disease ) .pptx
( Peptic ulcer disease ) .pptx ( Peptic ulcer disease ) .pptx
( Peptic ulcer disease ) .pptx
 
Pud Gastritis Lecture[1]
Pud Gastritis Lecture[1]Pud Gastritis Lecture[1]
Pud Gastritis Lecture[1]
 
Peptic ulcler disease
Peptic ulcler diseasePeptic ulcler disease
Peptic ulcler disease
 

More from MedicineAndHealthUSA

Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...MedicineAndHealthUSA
 
Hiv Infection And The Nervous System
Hiv Infection And The Nervous SystemHiv Infection And The Nervous System
Hiv Infection And The Nervous SystemMedicineAndHealthUSA
 
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...MedicineAndHealthUSA
 
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...MedicineAndHealthUSA
 
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...MedicineAndHealthUSA
 
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...MedicineAndHealthUSA
 
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...MedicineAndHealthUSA
 
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...MedicineAndHealthUSA
 

More from MedicineAndHealthUSA (20)

Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...
 
After Fellowship
After FellowshipAfter Fellowship
After Fellowship
 
Salzer
SalzerSalzer
Salzer
 
Hiv Infection And The Nervous System
Hiv Infection And The Nervous SystemHiv Infection And The Nervous System
Hiv Infection And The Nervous System
 
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
Thyroid Benign Slides
Thyroid Benign SlidesThyroid Benign Slides
Thyroid Benign Slides
 
The Challenge Of Acute Back Pain
The Challenge Of Acute Back PainThe Challenge Of Acute Back Pain
The Challenge Of Acute Back Pain
 
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
 
Hiv Vaccines Overview
Hiv Vaccines OverviewHiv Vaccines Overview
Hiv Vaccines Overview
 
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...
Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Expo...
 
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
 
low Back pain
low Back painlow Back pain
low Back pain
 
Calcium disorder
Calcium disorderCalcium disorder
Calcium disorder
 
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
 
Diabetes Care Alphabet Strategy
Diabetes Care Alphabet StrategyDiabetes Care Alphabet Strategy
Diabetes Care Alphabet Strategy
 
Diabetes
DiabetesDiabetes
Diabetes
 
Balasubramanian K5 Oct 21 230pm
Balasubramanian K5 Oct 21 230pmBalasubramanian K5 Oct 21 230pm
Balasubramanian K5 Oct 21 230pm
 

Recently uploaded

Intramuscular & Intravenous Injection.pptx
Intramuscular & Intravenous Injection.pptxIntramuscular & Intravenous Injection.pptx
Intramuscular & Intravenous Injection.pptxsaranpratha12
 
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...Sheetaleventcompany
 
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...soniya pandit
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Dipal Arora
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
Shazia Iqbal 2024 - Bioorganic Chemistry.pdf
Shazia Iqbal 2024 - Bioorganic Chemistry.pdfShazia Iqbal 2024 - Bioorganic Chemistry.pdf
Shazia Iqbal 2024 - Bioorganic Chemistry.pdfTrustlife
 
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...Sheetaleventcompany
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacyDrMohamed Assadawy
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...Sheetaleventcompany
 
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan CytotecJual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotecjualobat34
 
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...Namrata Singh
 
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service DehradunDehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service DehradunSheetaleventcompany
 
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...GENUINE ESCORT AGENCY
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Sheetaleventcompany
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Sheetaleventcompany
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Sheetaleventcompany
 
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...Sheetaleventcompany
 
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...GENUINE ESCORT AGENCY
 

Recently uploaded (20)

Intramuscular & Intravenous Injection.pptx
Intramuscular & Intravenous Injection.pptxIntramuscular & Intravenous Injection.pptx
Intramuscular & Intravenous Injection.pptx
 
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...
Nagpur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Nagpur No💰...
 
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Shazia Iqbal 2024 - Bioorganic Chemistry.pdf
Shazia Iqbal 2024 - Bioorganic Chemistry.pdfShazia Iqbal 2024 - Bioorganic Chemistry.pdf
Shazia Iqbal 2024 - Bioorganic Chemistry.pdf
 
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...
👉 Amritsar Call Girls 👉📞 8725944379 👉📞 Just📲 Call Ruhi Call Girl Near Me Amri...
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacy
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
 
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan CytotecJual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
 
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
 
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service DehradunDehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun
 
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
 
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...
👉Chandigarh Call Girl Service📲Niamh 8868886958 📲Book 24hours Now📲👉Sexy Call G...
 
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...
Genuine Call Girls Hyderabad 9630942363 Book High Profile Call Girl in Hydera...
 

Peptic Ulcer Disease.Ppt.Fmdrl

  • 1. Peptic Ulcer Disease Ramona Carter-Burdine M.D. UTMB Galveston, Tx
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38. Moving on to Treatment Options……….
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46. H Pylori Treatment http://www.drugdigest.org/DD/Comparison/NewComparison/0,10621,550540-21,00.html Cure Rate Side Effect Rating 81-92% low-medium Prevpak 80-85% medium-high Helidac + H2 blocker Combination Products 80-90% medium Amoxicillin + Metronidazole + PPI 80-90% medium-low Amoxicillin + Clarithromycin + PPI 80-90% medium Clarithromycin + Metronidazole + PPI Three Drug Regimens
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.