The stomach and duodenum are described along with peptic ulcers. Peptic ulcers are caused by H. pylori infection, NSAIDs, Zollinger-Ellison syndrome, and smoking. Patients present with epigastric pain relieved by food or antacids. Endoscopy is the preferred test to detect ulcers. Treatment involves eradicating H. pylori, acid suppression, and surgery for complications like perforation or bleeding.
Talking about gastritis & peptic ulcer disease ( definetions , clinical picture , diagnosis & treatment , complications ) , all informations are Up tu date of 2017
Talking about gastritis & peptic ulcer disease ( definetions , clinical picture , diagnosis & treatment , complications ) , all informations are Up tu date of 2017
In the vedio you can see how the presentation was supposed to be
The link :
http://www.youtube.com/watch?v=MFBdaSF-JqM
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https://www.dropbox.com/s/qg6ie3mpcbvp793/Gastric.Ulcer.ToPost.pptx
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Benigne diseases of stomach are one of the serious conditions of our world.... so here u get littlebit information about these diseases...hope it will help you for your future study about these diseases... thank you.
In the vedio you can see how the presentation was supposed to be
The link :
http://www.youtube.com/watch?v=MFBdaSF-JqM
To download my Animated presentation vist
https://www.dropbox.com/s/qg6ie3mpcbvp793/Gastric.Ulcer.ToPost.pptx
Thanks for watching
Benigne diseases of stomach are one of the serious conditions of our world.... so here u get littlebit information about these diseases...hope it will help you for your future study about these diseases... thank you.
A circumscribed ulceration of the GI mucosa occurring in areas exposed to acid and pepsin with a defect in the mucosa that extends through the
Muscularis mucosa into the
Submucosa or deeper.
This presentation is about Peptic Ulcer Disease. I presented it in 2017 to my colleagues at Al Ain hospital. Information provided is up to date. I allow you to use it for educational purposes.
Gastritis is inflammation in the soft mucous lining of your stomach. This lining is a protective barrier in your stomach. When it’s inflamed, it means it’s under attack. It might be from an infection, a substance you ingested or digestive chemicals.
peptic ulcer disease is the presence of one or more ulcerative lesions in the stomach or duodenum.
for more informations you can read the following file.
Gastrointestinal Diseases
Group 5:
Leticia Bernal Leon
Daydig Rodriguez
Maria Rodriguez
Karina Silveira
Instructor:
Dr. Alain Llanes Rojas, DNP, APRN, FNP-BC
Miami Regional University
Diagnosis, Symptoms & Illness Management
MSN5600
Gastroesophageal Reflux
Gastroesophageal reflux that does not cause symptoms is known as physiologic reflux. In nonerosive reflux disease (NERD), individuals have symptoms of reflux disease but no visible or minimal esophageal mucosal injury
Gastroesophageal reflux disease (GERD) is the reflux of acid and pepsin or bile salts from the stomach to the esophagus that causes esophagitis. The severity of the esophagitis depends on the composition of the gastric contents and esophageal mucosa exposure time.
Definition & Classification
Gastroesophageal Reflux
Causes
GERD can be caused by abnormalities or alterations in
1. Lower esophageal sphincter function
2. Esophageal motility
3. Gastric motility or emptying
Esophageal function studies include the following:
Determination of the lower esophageal sphincter (LES) pressure (manometry)
Graphic recording of esophageal swallowing waves, or swallowing pattern (manometry)
Detection of reflux of gastric acid back into the esophagus (acid reflux)
Detection of the ability of the esophagus to clear acid (acid clearing)
An attempt to reproduce symptoms of heartburn (Bernstein test)
Gastroesophageal Reflux
Risk Factors
Obesity
Hiatal hernia
Use of drugs or chemicals that relax the LES (anticholinergics, nitrates, calcium channel blockers, nicotine)
Cigarette smoke.
Trigger Factors
Coughing
Vomiting
Straining at stool
Asthma
Chronic cough
Sinusitis.
Gastroesophageal Reflux
Common Symptoms
Heartburn that occurs 30 to 60 minutes after meals and when the patient bends over or lies down.
Regurgitation of sour or bitter gastric contents
Belching, and fullness of the stomach
Upper abdominal pain within 1 hour of eating.
Atypical Symptoms
chronic cough
asthma attacks
chronic laryngitis
sinusitis
discomfort during swallowing.
Noncardiac chest pain.
Dysphagia
Gastroesophageal Reflux
Clinical manifestations are related to mucosal injury from acid regurgitation and the frequency and duration of reflux events.
The symptoms worsen if the individual lies down or if intraabdominal pressure increases because of coughing, vomiting, or straining at stool.
Uncomplicated GERD that is responsive to first-line therapy does not require an endoscopy.
Patients who do not respond to therapy and those with suspected complications should undergo an endoscopic examination
Management & Evaluation
Differential diagnosis
Gastritis
Peptic ulcer
Gastric cancer
Cholelithiasis
Angina pectoris.
Gastroesophageal Reflux
Diagnosis of GERD is based on the history and clinical manifestations.
An upper endoscopy with biopsy is the standard diagnostic procedure for GERD. It confirms the diagnosis and documents the type and extent of tissue damage.
Esophageal endoscopy: shows hyperemia ...
Helicobacter pylori (H. pylori) infection is a common bacterial infection that affects the stomach lining and is associated with various gastrointestinal conditions, including gastritis, peptic ulcers, and even stomach cancer. While H. pylori infection can cause discomfort and complications, effective H. Pylori Infection Treatment strategies are available to manage the infection and promote healing.
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Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
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According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
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The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
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The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Lec5 gastritis, peptic ulcer
1.
2. Stomach: The stomach acts retaining
and grinding food, then actively
propelling it into the upper small
bowel. It’s divided into four regions;
the cardia, the fundus, the body, and
the antrum: which end by pyloric
channal.
3.
4. Duodenum: The most proximal
portion of the small intestine, forms a
C-shaped loop around the head of the
pancreas and is in continuity with the
pylorus proximally and the jejunum
distally. Angular changes in course
divide the duodenum into four
portions. The first part of the
duodenum is the duodenal bulb or
cap.
5.
6. Peptic ulcer: refers to an ulcer in the
lower esophagus, stomach or
duodenum, in the jejunum after
surgical anastomosis to the stomach
or, rarely, in the ileum.
Ulcer may be acute or chronic, but
acute ulcer shows no evidence of
fibrosis.
7.
8. 1- H. pylori infection; 90% of duodenal ulcer
patients and 70% of gastric ulcer patients are
infected with H. pylori.
H. pylori: is Gram-negative, spiral and has
multiple flagella at one end which make it motile,
allowing it to burrow and live deep beneath the
mucus layer closely adherent to the epithelial
surface. Production of the enzyme urease, this
produces ammonia from urea and raises the pH
around the bacterium. It spread by person-to-
person contact via gastric refluxate or vomit. H.
pylori exclusively colonize gastric-type
epithelium
9.
10.
11. 2-Non-steriodal anti-inflammtory drugs
(NSAIDs): NSAIDs induce ulcer by reducing
mucosal resist.– decrease Prostaglandin–
mucous Injury.
3-Zollinger-Ellison syndrome (ZES): gastrin-
secreting tumors, accounts for 0.1% of causes
of PUD.
4-Smoking: increased risk of GU and, to a
lesser extent DU, more complications, less
healing.
12. 1- PUD chronic condition with a history of
spontaneous relapse and remission lasting
for decades.
The most common presentation ---recurrent
abdominal pain ---three characters.
A-Localization to the epigastrium.
B- Relationship to food.
C- Episodic occurrence.
13. 2- Epigastric pain described as a burning or
discomfort, hunger pain, relieved by antacids or
food, awakes the patient from sleep, Wt. gain.
3- Vomiting occurs in about 40%
In some patients --silent ulcer; anemia from
chronic undetected blood loss.
4- Complications:
Hematemesis, or acute perforation.
5- The pain pattern in GU patients may be
different from that in DU patients, where
discomfort may actually be precipitated by food.
Nausea and weight loss occur more commonly in
GU patients.
14. 1- Endoscopy is the preferred
investigation. Gastric ulcers must
always be biopsied.
2- Barium studies
3- Tests for Detection of H. pylori
infection
15.
16. The aims of management are to relieve
symptoms, induce healing and prevent
recurrence.
1- H. pylori eradication.
2- General measures.
3- Short term management.
4- Maintenance treatment.
5- Surgical treatment
17. 1- REGIMENS FOR H. PYLORI ERADICATION :
A- 'First-line therapy is a proton pump inhibitor
(12-hourly), clarithromycin 500 mg 12-hourly,
and amoxicillin 1 g 12-hourly or metronidazole
400 mg 12-hourly, for 7 days.
B- Second-line therapy is a proton pump
inhibitor (12-hourly), bismuth 120 mg 6-hourly,
metronidazole 400 mg 12-hourly, and
tetracycline 500 mg 6-hourly, for 7 days.‘
2- General measures Cigarette smoking, aspirin
and NSAIDs should be avoided.
3- Short-term management: after H pylori
eradication, followed by continuous acid
suppression drugs (H2 RB or PPI) for 4-
18. 4- Maintenance treatment: GU needs 8-
12wks to complete healing, with repeated
endoscopy and biopsy.
5- Surgical treatment:
A- Emergency: Perforation, Hemorrhage.
B- Elective: Complications, e.g. gastric
outflow obstruction. Recurrent ulcer following
gastric surgery.
19. A- Complications of gastric resection or vagotomy:
1- Dumping
2- Bile reflux gastritis
3- Diarrhea and maldigestion
4- Weight loss
5- Anemia
6-Metabolic bone disease
7- Gastric cancer
B- Complications of PUD itself:
1- Perforation
2- Bleeding
3- Gastric outlet obstruction
