Question

what is medical treatment and surgery for peptic ulcer disease?

medication that they use for peptic ulcer?

Answer 1

Peptic Ulcer

it is an excavation formed in the mucosal wall of the stomach , pylorus, duodenum or esophagus.It is frequently reffered to asa gastric, duodenal, or easophagal ulcer depending on its location

(Peptic ulcer or stomach ulcer is a sore that develops in the lining of the oesophagus, stomach or small intestine.)

Causes

The bacteria H Pylori

long time use of NSAIDS Eg Ibuprofen, Naproxen sodium

Clinical Manifestations

• dull , gnawing pain and a burning sensation in the mid epigastrium or in the back
• pain is realived by eating or taking alkali, once the stomach emptied the pain returns
• pyrosis(heartburn)
• vomiting is rare
• constipation or diarrhea may result from diet and medications
• bleeding and tarry stools may occure.

Medical Management

The goal of to treatment are eradicate H. pylori and Gastric injury.

1.Life style changes

• Stress reduction and rest are priority interventions.
• Smoking cessation is strongly encouraged because smoking raise duodinal acidity and significantly inhibits ulcer repair . Support groups may helpful.
• Diatery modifications may be helpful. Patient should eat whatever agrees with them ; small, frequent meals are not necssary if antacids or histamine blockers are part of therapy.
• Diet in rich in milk and cream should be avoided also because they are potent acid stimulators
• Alcohol, and coffinated beverages should be avoided

2.Pharmacologic Therapy

• Antibiotics combined with proton pump inhibitors (PPI) and bismuth salts to supress H pylori
• H2 receptor antagonists to decrease stomach secreations
• Cytoprotective agents( protect mucosal cells from acid or NSAIDs)
• Antacids in combination with Cimetidine for treatment of stress ulcer and for prophylactic use Eg Ranitidine, Tagamet
• Anticholinergics to inhibit acid secreation

Surgical Management

• With the advent H2 receptor antagonists, surgical intervention is less common
• If recommended, surgery usually for intractable ulcers( particularly with Zollinger- Ellison syndrom), life threatining hemorrage, perforation or obstruction
• Surgical procedures include vagotomy, Vagotomy with pyloroplasty, or Billroth 1 or 2

Bleeding gastric ulcers should be resected, if possible. For massive hemorrhage from stress ulceration requiring surgery, near-total or total gastrectomy should be performed. Perforated duodenal ulcers are best managed by closure and a definitive ulcer operation, such as vagotomy-pyloroplasty.

medication that they use for peptic ulcer? ( Already explained in Pharmocologycal Management please go through it)

Proton pump inhibitors — also called PPIs — reduce stomach acid by blocking the action of the parts of cells that produce acid. Eg omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium) and pantoprazole (Protonix).