This ppt contains informations about GERD, peptic ulcer and gastritis

1. REFLUX DISEASE, GASTRITIS AND
PEPTIC ULCER
GREESHMA KRISHNAKUMAR

2. GASTROESOPHAGEAL REFLUX
DISEASE
 Gastro-esophageal reflux disease is a common condition, where acid from the stomach
leaks up into the esophagus .
 Acid reflux happens because the lower esophageal sphincter, doesn’t close properly
when food arrives at your stomach. Acid backwash then flows back up through your
esophagus into your throat and mouth, giving you a sour taste.

3. ETIOLOGY
Factors that can lead to this include:
 Too much pressure on the abdomen. Some pregnant women experience
heartburn almost daily because of this increased pressure.
 Particular types of food (for example, dairy, spicy or fried foods) and eating
habits.
 Medications that include medicines for asthma, high blood pressure and allergies;
as well as painkillers, sedatives and anti-depressants.
 A hiatal hernia -The upper part of the stomach bulges into the diaphragm, getting
in the way of normal intake of food.
 Smoking

4. CLINICAL FEATURES
 heartburn (an uncomfortable burning sensation in the chest that often occurs after
eating)
 Regurgitation
 esophagitis (a sore, inflamed esophagus)
 bad breath
 bloating and belching
 pain when swallowing and/or difficulty swallowing
 coughing

5. COMPLICATIONS
 Esophagitis
 Esophageal strictures and ulcers
 Hemorrhage
 Perforations
 Aspiration
 Development of Barret’s esophagus
 Precipitation of asthma attack

6. DIAGNOSIS
 Upper endoscopy
 Esophageal manometry
 Ambulatory acid (pH) probe test
 X-ray of the upper digestive system

7. TREATMENT
 Antacids that neutralize the acid in the stomach (ex: Mylanta, Rolaids, Tums)
 H2 receptor blockers- cimetidine (Tagamet HB), famotidine (Pepcid AC) and
nizatidine (Axid AR)
 Proton Pump Inhibitors(PPI) stronger acid blockers and allow time for damaged
esophageal tissue to heal-esomeprazole (Nexium), lansoprazole (Prevacid),
omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and
dexlansoprazole (Dexilant).

8. Things you can do to help
 Maintain a healthy weight – excess pounds put pressure on abdomen
 Stop smoking – relaxes the lower esophageal sphincter
 Elevate head of bed by 6 inches – if you have heartburn while trying to sleep
 Don’t lie down after a meal – wait at least 3-4 hours
 Eat food slowly and chew slowly – put down fork after a bite
 Avoid trigger foods – fried or fatty foods, alcohol, chocolate, coffee

9. GASTRITIS

10.  Gastritis is an inflammation, irritation, or erosion of the lining of the stomach
 The inflammation can either occur suddenly and is usually short-lived or lasts for
a long time, leading to more severe complications. The classification of gastritis
depends on the time course of the disease.
 Two types- Acute gastritis and chronic gastritis

13. ACUTE GASTRITIS
 Acute gastritis is a medical condition characterized by the sudden
inflammation of the stomach lining. It is accompanied by typical stomach and
bowel problems that usually resolve in a few days through medication. The
inflammation could involve the entire stomach or a particular region

14. ETIOLOGY
 bacterial infection from contaminated food or water sources
 nonsteroidal anti-inflammatory drugs (NSAIDs)
 excessive alcohol consumption
 severe stress
 autoimmune disorders
 direct injury to the stomach lining

15. CLNICAL FEATURES
 discomfort or pain in the abdomen
 nausea
 vomiting
 loss of appetite
 belching or bloating
 indigestion
 hiccups
 weakness.

16. DIAGNOSIS
 medical history, physical examination, and diagnostic tests.
 The diagnostic tests include endoscopy, blood test, stool test, and breathing test.

17. TREATMENT
 Antacids
 proton pump inhibitors (PPI)
 histamine H-receptor antagonists (H2 blockers)
 Dietary changes, lifestyle modifications, rest, and hydration are required to
relieve symptoms and heal the stomach lining.

18. CHRONIC GASTRITIS
 Chronic gastritis is a long-term inflammation of the stomach lining that can
persist for months or even years
 Type A gastritis (caused by the immune cells of the body, called autoimmune
gastritis), Type B gastritis (caused by H. pylori infection), and Type C gastritis
(caused by prolonged use of NSAIDs).

19. ETIOLOGY
 H.pylori
 overuse or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs),
such as ibuprofen and naproxen
 excessive alcohol consumption
 chronic stress
 injuries and impact
 exposure to radiation
 recurring bile reflux from the small intestine

20. CLINICAL FEATURES
 indigestion
 a burning or gnawing feeling in the stomach
 the sensation of being full after eating a small amount
 nausea and vomiting
 belching
 unintentional weight loss
 bloating
 loss of appetite
 upper abdominal pain or discomfort
 bleeding, usually only in erosive gastritis

21.  antibiotics to eliminate H. pylori infection.
 Medications could also include H2-blockers and proton pump inhibitors (PPIs) to
relieve symptoms

22. COMPLICATIONS
 Bleeding from an erosion or ulcer
 Gastric outlet obstruction due to edema
 Dehydration from vomiting
 Renal insufficiency as a result of dehydration
 Perforation and peritonitis
 Peptic ulcer disease
 Nutrient deficiencies (Vitamin B12 deficiency, iron deficiency)

23. DIAGNOSIS
 medical history
 physical exam
 stool tests to check for both H. pylori and signs of bleeding
 Endoscopy when a camera on a tube is put down the throat into the stomach
 blood tests
 X-rays
 urea breath test to check for H. pylori infections

24. TREATMENT
 Antacids
 Proton pump inhibitors
 H2 blockers

25. PEPTIC ULCER

26.  Peptic ulcers are open sores that develop on the inside lining of your stomach and
the upper portion of your small intestine
 Peptic ulcers include:
• Gastric ulcers that occur on the inside of the stomach
• Duodenal ulcers that occur on the inside of the upper portion of your small
intestine (duodenum)

28. ETIOLOGY
 Helicobacter pylori (H. pylori)
 Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
 Taking other medications along with NSAIDs such as steroids, anticoagulants,
low dose aspirin, SSRIs, alendronate and risedronate can greatly increase the
chance of developing ulcers

29. CLINICAL FEATURES
 Burning stomach pain
 Feeling of fullness, bloating or belching
 Intolerance to fatty foods
 Heartburn
 Nausea

30.  Less often, ulcers may cause severe signs or symptoms such as:
• Vomiting or vomiting blood — which may appear red or black
• Dark blood in stools, or stools that are black or tarry
• Trouble breathing
• Feeling faint
• Nausea or vomiting
• Unexplained weight loss
• Appetite changes

31. COMPLICATIONS
 Internal bleeding
 A hole (perforation) in your stomach wall
 Obstruction
 Gastric cancer

32. DIAGNOSIS
 Laboratory tests for H. pylori
 Endoscopy
 Upper gastrointestinal series

33. TREATMENT
 Antibiotic medications to kill H. pylori-amoxicillin (Amoxil), clarithromycin
(Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline and
levofloxacin.
 Proton pump inhibitors- omeprazole (Prilosec), lansoprazole (Prevacid),
rabeprazole (Aciphex), esomeprazole (Nexium) and pantoprazole (Protonix).
 Histamine (H-2) blockers- famotidine (Pepcid AC), cimetidine (Tagamet HB) and
nizatidine (Axid AR)
 Antacids that neutralize stomach acid
 Medications that protect the lining of your stomach and small intestine- sucralfate
(Carafate) and misoprostol (Cytotec).