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Gastric Ulcer
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  • 1. Gastric Ulcers
    Jackie Freeman, Stephanie Janigo, Ryan Barlow and Ayla Hopkins
  • 2. Definition
    “A gastric ulcer is a pathology in which conditions within the stomach result in cell damage or cell death and therefore erosion of the stomach wall. The blood vessels within the stomach wall may also be damaged, and bleeding can result, and chronic inflammation can lead to the development of stomach cancer.”
    -Janice Lapsansky
  • 3. Peptic Ulcer
    Esophageal
    Gastric
    Duodenal
  • 4. Complications of Gastric Ulcers
    Vomiting, nausea, loss of appetite, bloody/tarry stools, severe abdominal pain
    Penetration/Perforation
    Bleeding
    Obstruction
    Cancer
  • 5. Aspirin
    Is a secretagogue
    Acetylsalicyclic acid in Aspirin inhibit Goblet cells from producing mucous in stomach
    Increases Gastric acid secretion from Parietal cells by means of…
    release of histamine, opening of Calcium channels, and inhibition of Prostaglandins
    breakdown of Aspirin
    http://www.bmb.leeds.ac.uk/teaching/icu3/mdcases/ws1/image112.gif
  • 6. Helicobacter Pylori Infection
    Bacteria that proliferates in the stomach of mammals
    ½ world’s population thought to be carriers
    Bacteria weakens the gastric mucosa lining the stomach
    Digestive acids combined with H. pylori irritate the stomach lining resulting in an ulcer
    http://www.hopkins-gi.org/
  • 7. Helicobacter Pylori Infection
    Pathogenicity is unknown
    Infection rate is inversely related to socioeconomic status
    Transmitted in feces and saliva
    Detected through gastrointestinal endoscopy
    Can result in a predisposition to gastric carcinoma
    http://en.wikipedia.org/wiki/File:Adenocarcinoma_of_the_stomach.jpg
    http://www.medgadget.com/archives/img/hpylori_lg.jpg
  • 8. Stress
    Not a direct cause of ulcers
    Makes one more prone
    Hypothalamus  Adenohypophysis releases ACTH ZonaFasiculata of the Adrenal Medulla releases Cortisol
    Cortisol causes hypersecretion of gastric acids and thins the protective mucosal lining of the stomach
    H. pylori can thrive
    Makes it harder for one to heal
    If in fight or flight mode, you release epinephrine, your immune system is depressed
    H. pylori can thrive
    Peptic ulcer cases multiply after natural disasters
  • 9. Positive feedback mechanisms
    Stress
    Aspirin
    H. Pylori
    Stress
    Ulcers
    Aspirin can cause gastric ulcers
    gastric ulcers are painful
    Take more Aspirin to decrease pain
    H. pylori releases pro-inflammatory
    release of nutrients that sustain H. pylori
  • 10. STOMACH
  • 11. References
    Dragstedt, L. R., Ragins, H., Dragstedt, L. R. II., & Evans, S. O. (1956). Stress and duodenal ulcer. Annals of Surgery, 144, 450-462.
    Levine, R. A., Nandi, J., & King, R. L. (1990). Aspirin Potentiates Prestimulated Acid Secretion and Mobilizes Intracellular Calcium in Rabbit Parietal Cells. Journal Clinical Investigation, 86, 400 – 408.
    National Institute of Health.(2010). H. pylori and Peptic Ulcers. http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/#1
    Nomura, A., Stemmermann, G.,Chyou, G., Perez-Perez, G.,& Blaser, J. (1994). Helicobacter pylori Infection and the Risk for Duodenal and Gastric Ulceration . Annals of Internal Medicine, 120, 977-981.
    Peptic ulcer disease. (2010). MedicineNet.Com. http://www.medicinenet.com/peptic_ulcer/article.htm
    Peptic Ulcers. (2006). The Merck Manuals Online Medical Library. http://www.merck.com/mmhe/sec09/ch121/ch121c.html
  • 12. Treatment
    Time
    STRESS LESS!
    Antacids
    H2 blockers
    Proton-pump inhibitors
    Antibiotics
    Surgery
    Vagotomy