peptic ulcer

1. Peptic Ulcer

2. Peptic Ulcer
Peptic ulcer :-
It can defined as ‘hole in the mucosa’ of any
portion of gastrointestinal tract exposed to acid pepsin
secretion. Duodenal ulcer and gastric ulcer are main types of
peptic ulcers.

3. Etiology :-
 Helicobacter pylori (90% of duodenal ulcer and
70% of gasrtic ulcer).
 NSAIDS (Aspirin, Diclofenac etc.)
 Smoking increases the risk for gastric ulcer.
 Heredity.
 personality.
 Imbalance between acid-pepsin digestion and
mucosal resistance.
 Tobacco.

4. Pathophysiology :-
Smoking, Emotional stress Reduction in blood flow
Reduction of mucosal
resistance
Peptic ulcer
Reduce generation
power of epithelial cell
Increased action of
acid-pepsin Reduced mitotic activity
H. Pylori infection Steroid therapy
& NSAIDs

5. Signs and Symptoms :-
 Abdominal pain.
 Epigastric pain
 Hunger pain
 Night pain
 Heartburn
 Loss of appetite
 Vomiting
 Headache
 Nausea

6. Treatment :-
 Non- Pharmacological :-
 Life style changes.
 Stop smoking , alcohol and tobacco.
 Avoidance of NSAIDs.
 Normal regular diet .
 Avoid spicy food- chilly and sour food.
 Avoid the stress, tension .

7.  Pharmacological :-
 Triple therapy :-
Lansoprazole 30mg + Clarethromycine 500mg + Amoxicillin
500mg all drugs are give BD.
 Quadruple therapy :-
CBS 120mg QID + Tetracycline 500mg QID + Metronidazole
400mg TDS + Pantoprazole 40 mg BD
 H2- blockers :-
Ranitidine - 150mg BD up to 8 weeks.
 Proton pump inhibitors :-
Pantoprazole – 40mg OD up to 4-8 weeks.
 Antacid neutrilized stomach existing stomach acid and can
provide rapid pain relief. Examples Aluminium hydroxide ,
magnesium hydroxide , Calcium carbonate etc.