The document discusses peptic ulcers, which are sores in the lining of the stomach or duodenum caused by an imbalance between defensive and damaging factors. Key points include: Helicobacter pylori bacteria and NSAIDs are major causes of ulcers. Symptoms include abdominal pain relieved by food or antacids. Complications can include bleeding, perforation, or obstruction if not treated. Treatment involves antibiotics to eliminate H. pylori, acid reducers to promote healing, and lifestyle changes like quitting smoking.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They're usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
In the vedio you can see how the presentation was supposed to be
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http://www.youtube.com/watch?v=MFBdaSF-JqM
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This ppt is suitable for b.pharma students. This ppt is prepared according to b.pharma IInd semester syallbus. In this ppt we provide all topics related to pathophysiology of peptic ulcer. In this ppt we covered introduction, types, sign & symptoms, pathophysiology, diagnosis, complications and treatments.
GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
CHRONIC DYSPEPSIA
Seminar Prepared by :-
Ali Abdulazeem
Shilan Adnan Abdulrahman
Alaa Shamil
Guldan Hameed
Internal Medicine
College of Medicine - University of Kirkuk
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They're usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
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
This ppt is suitable for b.pharma students. This ppt is prepared according to b.pharma IInd semester syallbus. In this ppt we provide all topics related to pathophysiology of peptic ulcer. In this ppt we covered introduction, types, sign & symptoms, pathophysiology, diagnosis, complications and treatments.
GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
CHRONIC DYSPEPSIA
Seminar Prepared by :-
Ali Abdulazeem
Shilan Adnan Abdulrahman
Alaa Shamil
Guldan Hameed
Internal Medicine
College of Medicine - University of Kirkuk
Evaluation of drug means confirmation of its identity and determination of its quality and purity and detection of nature of adulteration.Evaluation of herbal drug is an important tool in the formulation of high quality herbal products. Quality of herb is
depends upon on many factors like cultivation, collection, drying, storage, processing for market etc. Now a day’s
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commercial market. A present overview covering various tool like morphological, microscopical, physical, chemical
and biological employed for evaluation of herbal drugs.
I am a professional pharmacist. These slides provide for pharmacy department students. These slides describe pathology some topics.
Such as peptic ulcer disease, Immunity etc.
The word Gastritis comes from two words “gastro” referring to the stomach and “itis” means inflammation.
Gastritis is an inflammation, irritation, or erosion of the lining of the stomach mucosa.
Inflammation of the lining of the stomach.
INCIDENCE:
The incidence of gastritis is highest in the fifth and sixth decades of life; men are more frequently affected than women. The incidence is greater in clients who are heavy drinkers and smokers.
Acute gastritis is considered one of the most common type of gastritis. This is a painful inflammation of the lining of the stomach that occur suddenly and may involve bleeding of the stomach mucosa
Chronic gastritis involve s long- term inflammation of the mucosal lining of the stomach and this inflammatory condition of upper digestive system can last for years.
Chronic gastritis, on the other hand, is more often found in older people
A localized loss of gastric as well as duodenal mucosa leads to the formation of peptic ulcer.
A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. A peptic ulcer in the stomach is called a gastric ulcer. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine (duodenum). An esophageal ulcer occurs in the lower part of your esophagus.
Peptic ulcer arises when the normal mucosal defense mechanisms (mucus blood flow formation of HCO3- PGE2 ) are impaired or overpowered by damaging factors (acids pepsin pylori)
Ulcers occur 5 times more commonly in the duodenum and 95% of them are found in pyloric channel
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
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Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
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http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
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2. CONTENTSCONTENTS
٭DEFINITION AND DESCRIPTIONDEFINITION AND DESCRIPTION
٭CLASSIFICATIONCLASSIFICATION
٭HISTORY CHARTHISTORY CHART
٭SYMPTOMSSYMPTOMS
٭CAUSESCAUSES
٭RISK FACTORSRISK FACTORS
٭COMPLICATIONSCOMPLICATIONS
٭TESTS AND DIAGNOSIS CHARTTESTS AND DIAGNOSIS CHART
٭TREATMENTTREATMENT
٭LIFE STYLE AND HOME REMEDIESLIFE STYLE AND HOME REMEDIES
٭STUDIES & RECENT RESEARCHESSTUDIES & RECENT RESEARCHES
3. DEFINITION AND DESCRIPTIONDEFINITION AND DESCRIPTION
♥ Peptic ulcers are produced by an imbalance between the gastro-
duodenal mucosal defense mechanisms and damaging forces of
gastric acid and pepsin, combined with superimposed injury from
environmental or immunologic agents.
♥The mucous membrane lining the digestive tract erodes and
causes a gradual breakdown of tissue. This breakdown causes a
gnawing or burning pain in the upper middle part of the belly
(abdomen).
4. ₪ As many as 80% of ulcers are associated with Helicobacter
pylori, a spiral-shaped bacterium that lives in the acidic
environment of the stomach.
₪ Ulcers can also be caused or worsened by drugs such as
aspirin and other NSAIDs.
₪ Although H. pylori infection is usually contracted in
childhood, perhaps through food, water, or close contact with
an infected individual. usually doesn't cause problems in
childhood, if left untreated it can cause gastritis (the irritation
and inflammation of the lining of the stomach), peptic ulcer
disease, and even stomach cancer later in life.
5. ₪ Contrary to general belief, more peptic ulcers arise in the
duodenum (first part of the small intestine, just after the
stomach) than in the stomach.
₪ Duodenal ulcers usually first occur between the ages of 30-50
years and are twice as common in men as in women.
₪ Stomach (or gastric) ulcers usually occur in people older than
60 years and are more common in women.
6.
7. Classification
₪ Stomach (called gastric ulcer)
₪ Duodenum (called duodenal ulcer)
₪ Oesophagus (called Oesophageal ulcer)
₪ Types of peptic ulcers:
₪ Type I: Ulcer along the lesser curve of stomach
₪ Type II: Two ulcers present - one gastric, one
duodenal
₪ Type III: Prepyloric ulcer
₪ Type IV: Proximal gastroesophageal ulcer
₪ Type V: Anywhere
9. YEAR NAME OF SCIENTISTS WORK
1900s First discovery of human gastric
bacteria
1958 Lykoudis
(general practitioner in Greece)
Treatment of patients for peptic
ulcer disease with antibiotics
1982 Barry Marshall & Robin Warren
(Two Australian scientists)
Helicobacter pylori was rediscovered
as a causative factor for ulcers
1987 First study showing that eradication
of the organism reduces
duodenal ulcer recurrence
1994 National Institutes of Health
convened a Consensus Panel that
issued guidelines for
management of ulcer cancer,
taking H. pylori into account
1996 The Food and Drug Administration
approves the first antibiotic for
treatment of ulcer disease
1997 Centers for Disease Control and
Prevention
Launched a national education
campaign to inform health care
providers and consumers about
the link between H. pylori and
ulcers.
11. Gastric versus duodenal ulcer — Although there is much overlap, symptoms of a
gastric ulcer may be different than those of a duodenal ulcer.
Duodenal ulcer — "Classic" symptoms of a duodenal ulcer include burning,
gnawing, aching, or hunger-like pain, primarily in the upper middle region of the
abdomen below the breastbone (the epigastric region). Pain may occur or worsen
when the stomach is empty, usually two to five hours after a meal. Symptoms may
occur at night between 11 PM and 2 AM, when acid secretion tends to be greatest.
Feel better when you eat or drink and then worse 1 or 2 hours later (duodenal ulcer)
Gastric ulcer — Symptoms of a gastric ulcer typically include pain soon after eating.
Symptoms are sometimes not relieved by eating or taking antacids.
Feel worse when you eat or drink (gastric ulcer)
12. SYMPTOMS
Burning painBurning pain bloatingbloating
NauseaNausea water brashwater brash
Unexplained weight lossUnexplained weight loss hematemesis (vomiting of blood)hematemesis (vomiting of blood)
Appetite changesAppetite changes MelinaMelina
vomitingvomiting Blood in the stoolsBlood in the stools
low blood cell count (anemia)low blood cell count (anemia) Stomach pain wakes you up at nightStomach pain wakes you up at night
frequent burping or hiccuppingfrequent burping or hiccupping An early sense of fullness with eatingAn early sense of fullness with eating
16. й Helicobacter pylori, a bacteria that is frequently found in theHelicobacter pylori, a bacteria that is frequently found in the
stomachstomach
й Nonsteroidal anti-inflammatory drugs (NSAIDS) such asNonsteroidal anti-inflammatory drugs (NSAIDS) such as
ibuprofenibuprofen
й In addition, smoking and certain other genetic andIn addition, smoking and certain other genetic and
environmental factors (such as medications) may influence theenvironmental factors (such as medications) may influence the
course of peptic ulcer disease.course of peptic ulcer disease.
й Psychological stress and dietary factors were once thought to bePsychological stress and dietary factors were once thought to be
the cause of ulcers, although these factors are no longer thoughtthe cause of ulcers, although these factors are no longer thought
have a major role.have a major role.
18. Helicobacter pylori infection
¤H. pylori is a helix-shaped
¤ Gram-negative, slow-growing organism
¤ about 3 micrometres long with a diameter of about
0.5 micrometres
¤has 4–6 flagella
¤ Helicobacter pylori is composed of a single circular chromosome
with 1,667,867 base pairs, containing about 1590 coding regions
¤It is microaerophilic; that is, it requires oxygen, but at lower
concentration than is found in the atmosphere
¤It contains a hydrogenase which can be used to obtain energy by
oxidizing molecular hydrogen (H2) that is produced by intestinal
bacteria
19. * It produces oxidase, catalase, and urease
* It is capable of forming biofilms and can convert
from spiral to a possibly viable but nonculturable
coccoid form, both likely to favor its survival and be
factors in the epidemiology of the bacterium.
22. ☻The bacterium persists in the stomach for decades in
most people. Most individuals infected by H. pylori
will never experience clinical symptoms despite
having chronic gastritis. Approximately 10-20% of
those colonized by H. pylori will ultimately develop
gastric and duodenal ulcers. H. pylori infection is also
associated with a 1-2% lifetime risk of stomach
cancer and a less than 1% risk of gastric MALT
lymphoma
23. • Regular use of pain relievers. Nonsteroidal anti-
inflammatory drugs (NSAIDs) can irritate the lining of
stomach and small intestine. These medications, which are
available both by prescription and over-the-counter, include
aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve),
ketoprofen and others. Other prescription medications that can
also lead to ulcers include medications used to treat
osteoporosis called bisphosphonates (Actonel, Fosamax and
others).
• NSAIDs inhibit production of an enzyme (cyclooxygenase)
that produces prostaglandins. These hormone-like substances
help protect stomach lining from chemical and physical injury.
Without this protection, stomach acid can erode the lining,
causing bleeding and ulcers.
24. ♣ Effects of smoking on PUDEffects of smoking on PUD
♣Increased rate of gastric emptyingIncreased rate of gastric emptying
♣Diminished pancreatic bicarbonate secretionDiminished pancreatic bicarbonate secretion
♣Decreased duodenal pHDecreased duodenal pH
♣Reduced mucosal blood flowReduced mucosal blood flow
♣Inhibition of mucosal prostaglandinsInhibition of mucosal prostaglandins
25. NICOTINE
parasympathetic nerveparasympathetic nerve
activity inactivity in
gastrointestinal tractgastrointestinal tract
increase
stimulation tostimulation to
the enterochromaffin-like cellsthe enterochromaffin-like cells
and G cellsand G cells
increases theincreases the
amountamount
of histamine andof histamine and
gastrin secretedgastrin secreted
26. • Gastrinomas (Zollinger Ellison syndrome), rare
gastrin-secreting tumors, also cause multiple and
difficult to heal ulcers.
• Excessive alcohol consumption Alcohol can irritate
and erode the mucous lining of stomach and increases
the amount of stomach acid that's produced. It's
uncertain, however, whether this alone can progress
into an ulcer or if it just aggravates the symptoms of
an existing ulcer.
27. • Caffeine
Beverages and foods that contain caffeine
can stimulate acid secretion in the
stomach. This can aggravate an existing
ulcer, but the stimulation of stomach acid
can't be attributed solely to caffeine.
28. Role of StressRole of Stress
♫ A study of peptic ulcer patients in a Thai hospital showed that chronic stress
was strongly associated with an increased risk of peptic ulcer, and a combination
of chronic stress and irregular mealtimes was a significant risk factoR.
♫ An expert panel convened by the Academy of Behavioral Medicine Research
concluded that ulcers are not purely an infectious disease and that psychological
factors do play a significant role. Researchers are examining how stress might
promote H. pylori infection.
♫ For example, Helicobacter pylori thrives in an acidic environment, and stress
has been demonstrated to cause the production of excess stomach acid. This was
supported by a study on mice showing that both long-term water-immersion-
restraint stress and H. pylori infection were independently associated with the
development of peptic ulcers.
♫ Physical stress, is different. It can increase the risk of developing ulcers,
especially in the stomach. Examples of physical stress that can lead to ulcers are
that suffered by people with injuries such as severe burns, and people undergoing
major surgery.
29. אָ The incidence of duodenal ulcers has dropped
significantly during the last 30 years, while the
incidence of gastric ulcers has shown a small
increase, mainly caused by the widespread use of
NSAIDs. The drop in incidence is considered to be a
cohort-phenomena independent of the progress in
treatment of the disease. The cohort-phenomena is
probably explained by improved standards of living
which has lowered the incidence of H. pylori
infections.
31. • You’re at risk for peptic ulcer disease if you:
• Are 50 years old or older.
• Diabetes may increase your risk of having H. pylori
• Drink alcohol excessively
• Smoke cigarettes or use tobacco.
• Have a family history of ulcer disease.
• You’re at risk for NSAID-induced ulcers if you:
• Are age 60 or older (your stomach lining becomes more fragile with age).
• Have had past experiences with ulcers and internal bleeding
• Take steroid medications, such as prednisone.
• Take blood thinners, such as warfarin.
• Consume alcohol or use tobacco on a regular basis.
• Experience certain side effects after taking NSAIDs, such as upset stomach
and heartburn.
• Take NSAIDs in amounts higher than recommended
• Take NSAIDs for long periods of time
• Stress does not cause an ulcer, but may be a contributing factor
• Chronic disorders such as liver disease, emphysema, rheumatoid arthritis
may increase vulnerability to ulcers
• Improper diet, irregular or skipped meals
• Type O blood (for duodenal ulcers)
33. ж Gastrointestinal bleeding is the most common
complication. Sudden large bleeding can be life-
threatening. It occurs when the ulcer erodes one of
the blood vessels. Bleeding can occur as slow blood
loss that leads to anemia or as severe blood loss that
may require hospitalization or a blood transfusion.
ж Perforation (a hole in the wall) often leads to
catastrophic consequences. Erosion of the gastro-
intestinal wall by the ulcer leads to spillage of
stomach or intestinal content into the abdominal
cavity. Perforation at the anterior surface of the
stomach leads to acute peritonitis, initially chemical
and later bacterial peritonitis. The first sign is often
sudden intense abdominal pain. Posterior wall
perforation leads to pancreatitis; pain in this situation
often radiates to the back.
34.
35. ж Penetration is when the ulcer continues into
adjacent organs such as the liver and pancreas
ж Scar tissue Scarring and swelling due to
ulcers causes narrowing in the duodenum and
gastric outlet obstruction. Patient often
presents with severe vomiting. Peptic ulcers
can also produce scar tissue that can obstruct
passage of food through the digestive tract,
causing you to become full easily, to vomit
and to lose weight.
36. WARNING SIGNSWARNING SIGNS
blood in your stoolsblood in your stools losing weightlosing weight
pain doesn't go awaypain doesn't go away
With medicationWith medication
vomit bloodvomit blood sudden, severe painsudden, severe pain
vomit food eaten hours orvomit food eaten hours or
days beforedays before
ongoing nausea orongoing nausea or
repeated vomiting.repeated vomiting.
feel cold or clammyfeel cold or clammy
feel unusually weak orfeel unusually weak or
dizzydizzy
41. GOALS OF TREATMENT
☻ lowering the amount of acid that stomach makes,
☻neutralizing the acid
☻ protecting the injured area so it can heal
☻ It's also very important to stop smoking and drinking alcohol
☻Prevent complications (bleeding, perforation, penetration,
obstruction)
☻Minimize recurrences
☻Reduce financial costs
42. Antibiotic medications. Doctors use combinations of antibiotics to treat H. pylori
because one antibiotic alone isn't always sufficient to kill the organism. Antibiotics
prescribed for treatment of H. pylori include amoxicillin (Amoxil), clarithromycin
(Biaxin) and metronidazole (Flagyl). Combination drugs that include two antibiotics
together with an acid suppressor or cytoprotective agent (Helidac, Prevpac) have
been designed specifically for the treatment of H. pylori infection.
Acid blockers. Acid blockers — also called histamine (H-2) blockers — reduce the
amount of hydrochloric acid released into digestive tract, which relieves ulcer pain
and encourages healing. Acid blockers work by keeping histamine from reaching
histamine receptors. Histamine is a substance normally present in body. When it
reacts with histamine receptors, the receptors signal acid-secreting cells in stomach
to release hydrochloric acid. Available by prescription or over-the-counter (OTC),
acid blockers include the medications ranitidine (Zantac), famotidine (Pepcid),
cimetidine (Tagamet) and nizatidine (Axid).
Antacids. An antacid may be taken in addition to an acid blocker or in place of one.
Instead of reducing acid secretion, antacids neutralize existing stomach acid and can
provide rapid pain relief.
43. ♪ Proton pump inhibitors. Another way to reduce stomach acid is to shut down the
"pumps" within acid-secreting cells. Proton pump inhibitors reduce acid by blocking the
action of these tiny pumps. These drugs include the prescription and over-the-counter
medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex) and
esomeprazole (Nexium). Doctors frequently prescribe proton pump inhibitors to promote
the healing of peptic ulcers. Proton pump inhibitors also appear to inhibit H. pylori.
♪ Cytoprotective agents. In some cases, your doctor may prescribe these medications that help
protect the tissues that line your stomach and small intestine. They include the prescription
medications sucralfate (Carafate) and misoprostol (Cytotec). Another nonprescription
cytoprotective agent is bismuth subsalicylate (Pepto-Bismol).
♪ Bowel rest: Bed rest and clear fluids with no food at all for a few days. This
gives the ulcer a chance to start healing without being irritated.
♪ Nasogastric tube: Placement of a thin, flexible tube through your nose and
down into your stomach. This also relieves pressure on the stomach and helps it
heal.
♪ Urgent endoscopy or surgery if indicated: Damaged, bleeding blood vessels
can usually be repaired with an endoscope. The endoscope has a small heating
device on the end that is used to cauterize a small wound.