PEPTIC ULCERS Gastroenterology University of Pretoria Pretoria Academic Hospital Obedy Mwantembe 04 May, 2004
Definition – Peptic Ulcer <ul><li>An ulcer in the </li></ul><ul><ul><li>Lower oesophagus </li></ul></ul><ul><ul><li>Stomac...
Ulcer or Erosion <ul><li>Muscularis Mucosae </li></ul><ul><li>Duodenal Ulcer </li></ul><ul><li>Oesophageal ulcers </li></u...
Epideomiology <ul><li>Up to 10-12% in one’s life time </li></ul>
Duodenal Ulcer <ul><li>Male:Female 5-2:1 </li></ul><ul><li>90% H.pyroli </li></ul>
Gastric Ulcer <ul><li>Male:Female 2:1 </li></ul><ul><li>Up to 70% h. pyroli </li></ul>
AETIOLOGY <ul><li>Helicobacter Pyroli </li></ul><ul><ul><li>Age 12 nearly 100% </li></ul></ul><ul><ul><li>Europe 30-40% </...
AETIOLOGY <ul><li>Heredity </li></ul><ul><ul><li>DU closer than GU especially if below 20y </li></ul></ul><ul><ul><li>Bloo...
AETIOLOGY <ul><li>Acid-pepsin and acid </li></ul><ul><li>Vs </li></ul><ul><li>Defensive factors (Gastric mucosal barrier) ...
CHRONIC ULCER <ul><li>90% in lesser curve within antrum  or at junction between body and antral mucosa (stomach) </li></ul...
THE CLINIC <ul><li>Recurrent abdominal pain </li></ul><ul><ul><li>Epigastrium </li></ul></ul><ul><ul><li>Related to food <...
 
 
 
 
 
 
 
 
Topics of Discussion <ul><li>State the main ideas you’ll be talking about </li></ul>
Topic One <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it ...
Topic Two <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it ...
Topic Three <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How i...
Real Life <ul><li>Give an example or real life anecdote </li></ul><ul><li>Sympathize with the audience’s situation if appr...
What This Means <ul><li>Add a strong statement that summarizes how you feel or think about this topic </li></ul><ul><li>Su...
Next Steps  <ul><li>Summarize any actions required of your audience </li></ul><ul><li>Summarize any follow up action items...
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peptic.ppt

  1. 1. PEPTIC ULCERS Gastroenterology University of Pretoria Pretoria Academic Hospital Obedy Mwantembe 04 May, 2004
  2. 2. Definition – Peptic Ulcer <ul><li>An ulcer in the </li></ul><ul><ul><li>Lower oesophagus </li></ul></ul><ul><ul><li>Stomach </li></ul></ul><ul><ul><li>Duodenum </li></ul></ul><ul><ul><li>Duodenum </li></ul></ul><ul><li>Acute or Chronic </li></ul>
  3. 3. Ulcer or Erosion <ul><li>Muscularis Mucosae </li></ul><ul><li>Duodenal Ulcer </li></ul><ul><li>Oesophageal ulcers </li></ul><ul><li>Small bowel ulcers </li></ul>
  4. 4. Epideomiology <ul><li>Up to 10-12% in one’s life time </li></ul>
  5. 5. Duodenal Ulcer <ul><li>Male:Female 5-2:1 </li></ul><ul><li>90% H.pyroli </li></ul>
  6. 6. Gastric Ulcer <ul><li>Male:Female 2:1 </li></ul><ul><li>Up to 70% h. pyroli </li></ul>
  7. 7. AETIOLOGY <ul><li>Helicobacter Pyroli </li></ul><ul><ul><li>Age 12 nearly 100% </li></ul></ul><ul><ul><li>Europe 30-40% </li></ul></ul><ul><ul><li>DU – 90% </li></ul></ul><ul><ul><li>GU – 70% </li></ul></ul><ul><li>Non-Steroidal anti-inflammatory drugs (NSAIDs) </li></ul><ul><ul><li>Inhibit cyclo-oxygenase activity </li></ul></ul><ul><ul><ul><li>Reduce formation of protective PGE </li></ul></ul></ul>
  8. 8. AETIOLOGY <ul><li>Heredity </li></ul><ul><ul><li>DU closer than GU especially if below 20y </li></ul></ul><ul><ul><li>Blood Group O </li></ul></ul><ul><li>Smoking </li></ul><ul><ul><li>GU than DU </li></ul></ul><ul><ul><li>Difficult healing </li></ul></ul><ul><li>Stress ulcers </li></ul>
  9. 9. AETIOLOGY <ul><li>Acid-pepsin and acid </li></ul><ul><li>Vs </li></ul><ul><li>Defensive factors (Gastric mucosal barrier) </li></ul><ul><li>No ulcer No acid (Pernicious Anaemia) </li></ul><ul><li>Too much acid – severe ulcerations </li></ul>
  10. 10. CHRONIC ULCER <ul><li>90% in lesser curve within antrum or at junction between body and antral mucosa (stomach) </li></ul><ul><li>Duodenal ulcers </li></ul><ul><ul><li>1 st part </li></ul></ul><ul><ul><li>50% anterior wall </li></ul></ul>
  11. 11. THE CLINIC <ul><li>Recurrent abdominal pain </li></ul><ul><ul><li>Epigastrium </li></ul></ul><ul><ul><li>Related to food </li></ul></ul><ul><ul><li>Episodic </li></ul></ul><ul><li>History a questionable indicator of the presence of an ulcer </li></ul>
  12. 20. Topics of Discussion <ul><li>State the main ideas you’ll be talking about </li></ul>
  13. 21. Topic One <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it relates to your audience </li></ul>
  14. 22. Topic Two <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it relates to your audience </li></ul>
  15. 23. Topic Three <ul><li>Details about this topic </li></ul><ul><li>Supporting information and examples </li></ul><ul><li>How it relates to your audience </li></ul>
  16. 24. Real Life <ul><li>Give an example or real life anecdote </li></ul><ul><li>Sympathize with the audience’s situation if appropriate </li></ul>
  17. 25. What This Means <ul><li>Add a strong statement that summarizes how you feel or think about this topic </li></ul><ul><li>Summarize key points you want your audience to remember </li></ul>
  18. 26. Next Steps <ul><li>Summarize any actions required of your audience </li></ul><ul><li>Summarize any follow up action items required of you </li></ul>
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