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PEPTIC ULCERSGastroenterologyUniversity of PretoriaPretoria Academic HospitalObedy Mwantembe04 May, 2004

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Definition – Peptic Ulcer An ulcer in the

Lower oesophagus Stomach Duodenum Duodenum

Acute or Chronic

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Ulcer or Erosion Muscularis Mucosae Duodenal Ulcer

Oesophageal ulcers Small bowel ulcers

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Epideomiology Up to 10-12% in one’s life time

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Duodenal Ulcer Male:Female 5-2:1 90% H.pyroli

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Gastric Ulcer Male:Female 2:1 Up to 70% h. pyroli

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AETIOLOGY Helicobacter Pyroli

Age 12 nearly 100% Europe 30-40% DU – 90% GU – 70%

Non-Steroidal anti-inflammatory drugs (NSAIDs) Inhibit cyclo-oxygenase activity

Reduce formation of protective PGE

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AETIOLOGY Heredity

DU closer than GU especially if below 20y

Blood Group O Smoking

GU than DU Difficult healing

Stress ulcers

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AETIOLOGY Acid-pepsin and acid Vs Defensive factors (Gastric mucosal

barrier) No ulcer No acid (Pernicious

Anaemia) Too much acid – severe

ulcerations

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CHRONIC ULCER 90% in lesser curve within antrum

or at junction between body and antral mucosa (stomach)

Duodenal ulcers 1st part 50% anterior wall

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THE CLINIC Recurrent abdominal pain

Epigastrium Related to food Episodic

History a questionable indicator of the presence of an ulcer

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Topics of Discussion State the main ideas you’ll be

talking about

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Topic One Details about this topic Supporting information and

examples How it relates to your audience

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Topic Two Details about this topic Supporting information and

examples How it relates to your audience

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Topic Three Details about this topic Supporting information and

examples How it relates to your audience

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Real Life Give an example or real life

anecdote Sympathize with the audience’s

situation if appropriate

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What This Means Add a strong statement that

summarizes how you feel or think about this topic

Summarize key points you want your audience to remember

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Next Steps Summarize any actions required of

your audience Summarize any follow up action

items required of you