according to PCI

1. By : ISHIKA CHOUDHARY
ARKA JAIN UNIVERSITY ,
JAMSHEDPUR

2.  It is a lesion in the lining {mucosa} of the
digestive tract , typically in the duodenum , or
stomach , caused by the digestive action of
pepsin and stomach acid.
 Lesion may subsequently occur into the
lamina propria and submucosa to cause
bleeding.
 Most of the peptic ulcer occur either in the
duodenum, or in the stomach.

3.  Life style: smoking, medications.
 H. Pylori infection: 90%have this bacterium;
passed from person to person(fecal-oral-
routeoral-oral-route)
 Age: duodenum(30-40) and gastric (over 50)
 Gender: more in older women.
 Genetic factor

4.  Under normal condition , a physiologic
balance exists between gastric acid secretions
and gastroduodenal mucosal defence.
 Peptic ulcer occur when balance between
aggressive factors and defensive mechanism
is disrupted.
 Aggressive factors such as NSAIDS, H. pylori
infection , can alter mucosal defence by
allowing back diffusion of H+ and
subsequent epithelial cell injury.

7.  Stool examination for fecal occult
blood.
 Complete blood count (CBC) for
decrease in blood cells.

8.  Esophago gastro deuodenoscopy (EGD)
 Upper gastrointestinal series
 Urea breath testing
 In all patients with ‘’alarming symptoms’’
endoscopy is required : anorexia ,
hematemesismelena , dysphagia .

9.  Hemmorrhage : blood vessels damaged as
ulcer erodes into the muscles of stomach wall.
 coffee ground vomiting (presence of
coagulated blood ) occult blood in tarry
stools.
 Perforation: an ulcer can erode through the
entire wall
 Narrowing and obstructions (pyloric )

10.  Epigastric pain
 Nausea
 Vomiting
 Significant weight loss
 Feeling of fullness
 Bloodydark tarry stools

11.  Life style modifications
 Hyposecretory drug therapy
 H . Pylori eradication therapy
 Surgery