1. Peptic Ulcers SBI3U

2. What is a Peptic Ulcer? • Ulcer of mucous membrane lining parts of alimentary tract exposed digestive juices • Includes esophagus, stomach, duodenum, parts small intestine http://www.umm.edu/patiented/articles/gi_bleeding_normal_anatomy_000128.htm

3. History of Ulcers • Factors: • Emotional stress • Hurried meals • Excessive drinking/smoking • Ingestion known drug-irritants • Seasons • Treatment: • Bed rest • Bland diet http://www.thegreenguide.org/article/food/alcohol http://www.kidsarus.org/volunteers/Volunteer_Leader_Training_Guide/2003/survival_visual3.htm

4. Symptoms of an Ulcer • Gnawing or burning or hungry feeling upper abdomen • Eating eases discomfort • Bloating • Nausea after eating • Bloody stool • Vomiting • Weight loss • Poor appetite

5. What Causes an Ulcer? • 80% gastric and 90% duodenal caused by bacteria Helicobacter Pylori • Hydrochloric acid and Pepsin damage stomach • Caffeine stimulates acid secretion • Caffeine aggravates existing ulcers • Smoking increases chances of developing ulcer • Smoking slows down healing process http://microbewiki.kenyon.edu/index.php/Helicobacter

6. Diagnosis • Endoscopy - small tube with camera and light on end inserted through mouth to locate ulcer • Upper Gastrointestinal Series - swallowing of liquid containing barium to locate ulcer • Blood, Breath, Stomach tissue tests - detect H. Pylori and ulcer http://www.umm.edu/patiented/articles/how_peptic_ulcers_diagnosed_000019_6.htm

7. What happens if an Ulcer goes Untreated? • Bleeding - ulcer eats muscle and may damage blood vessels  • Perforation - ulcer eats a hole in wall, may cause peritonitis  • Narrowing or Obstruction - ulcer swells or scars where stomach and duodenum meet, narrowing or closing hole resulting in vomiting contents  For all three: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease4&organ=5&disease=16&lang_id=1

8. Treating an Ulcer • Medications - H-2 Blockers, Acid Pump Inhibitors, Mucosal Protective Agents • Antiobiotics • Vagatomy • Antrectomy • Pyloroplasty For all three pictures: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease4&organ=5&disease=16&lang_id=1

9. Future Research • Biggest break through in research was discovery of Helicobacter Pylori in 1982 • Treatment has simplified with help of antibiotics • Still researching how and why get H. Pylori • Why not all people get ulcer that have H. Pylori • In future doctors hope to treat all ulcers with laparoscopic surgery • Less pain and short hospital stays, small scars

10. References • Branca, B. et. Al.(2003). Ulcers. In Diseases: Spider Bites to Zoonoses (Vol. 8, pp. 89-90). Danbury: Golier Educational. • Brunner, Lillian Sholtis. The Lippincott Manual of Nursing Practice. London: Blackwell Scientific Publications, 1974. • Healthlink.(2000) H. Pylori and Peptic Ulcers. Retrieved October 17, 2006 on the World Wide Web: http://healthlink.mcw.edu/article/956711536.html • The Ohio State University Medical Center.(2006) Peptic Ulcers Stomach and Duodenal Ulcers (Peptic Ulcers). Retrieved October 18, 2006 on the World Wide Web: http://medicalcenter.osu.edu/patientcare/healthinformation/diseasesan dconditions/digestive/peptic/ • University of Maryland Medical Center.(2006) Digestive Disorders Stomach and Duodenal Ulcers (Peptic Ulcers). Retrieved October 19, 2006 on the World Wide Web: http://www.umm.edu/digest/ulcers/htm