Peptic ulcer disease presentation for ordinary people

1. Dr. Sanzida Islam (9201)
Dr. Kazi A. K. M. Rasel (9202)
Dr. Md. Farid Ahmed (9203)
Dr. Afroza Sultana (9204)
Dr. Abu Toha Md. Shakil (9205)

3. Sites of Peptic Ulcer
Stomach
Duodenum
Lower end of esophagus
Jejunum

4. Causes of Peptic Ulcer
• H. Pylori
• NSAIDs
• Heredity
• Smoking
• Stress, spicy food
• steroid, alcohol

5. Pathology
Gastric ulcer is single. Usually in antrum or
junction between antrum and body.
Duodenum ulcer on first part, anterior wall.

6. Clinical Features
• Epigastric pain
• Heartburn, loss of appetite and vomiting

7. Difference between gastric and duodenal ulcer
• Periodicity
• Pain
• Vomiting
• Hemorrhage
• Appetite
• Diet
• Weight

8. Investigations
Endoscopy of upper GIT

9. Management: General Measures
Avoid smoking
Avoid pain killers
Regular meal
Avoid spicy foods

10. Management
H. Pylori eradication
Triple Therapy
Pain relieve
Antacid

11. Management
Healing ulcer and prevent relapse
 proton pump inhibitors
 H2 blocker
 Misoprostol
 Bismuth
 Sucralfate
Surgical Option

12. Differential Diagnosis
• Acute cholecystitis
• Acute pancreatitis
• Acute MI

13. Complications
 Acute
Perforation
Hematemesis/ melaena
 Intermediate
Residual abscess
 Chronic
Stenosis – pyloric stenosis, hour glass
contracture, tea pot deformity
Penetration into pancreas
Gastric cancer

14. Prevention
• Diet
• Avoid
 Smoking
 Alcohol
 Pain Killers
• Sanitation and food hygiene
• Reduce stress

15. Conclusion