WEEK : OESOPHAGUS AND STOMACH DISORDERS LECTURE: CLASSIFICATIONS: 4 PEPTIC ULCERS CAUSES: Found in the stomach and duodenum A crater like lesion where the mucosal lining is eroded Depending on the severity erosion can go deeper than mucosal layer and into the ssubmucosa where bleeding can occur In some instances ulceration can perforate through the entire lining (4 layers ) through the serosa as well H. pylori Gastric acid Papsin NSAIDS Symptoms and signs Epigastric pain that is relieved with ingestion of Food Peptic ulcer (Microscopic view) Necrotic cells 0 Blood vessel - Stomach pains sometime soon after a meal Duodenal ulcer - pain 2-3 hours after a meal Nausea Dyspepsia (abdominal upset) MANAGEMENT: Eradication of H. pylori Reduction in the use of NSAIDS Avoiding alcohol, smoking Reduced stress GASTRITIS CLASSIFICATIONS: Inflammation of the mucosal lining in the stomach Asymptomatic H. pylori NSAIDS Mild epigastric pain Nausea/vomiting CAUSES: Alcohol Gastritis Due to the pathogen H. pylori Implicated in the development OF peptic ulcers NSAIDS Excessive long-term use Eventually lead to the development of peptic ulcers Disruption to the slightly alkaline mucus of the stomach A breakdown in the normally protective gastric epithelial lining Pronounced vagus nerve Mucosa Submucosa stimulation causes more HCI to be produced Muscularis externa Helicobacter Pilgri Induction Loithelia -Sammatins COMPLICATIONS GI tract bleeding Gastric cancer Eanghagen Weakness or injury to the mucus-lined barrier COMPLICATIONS: Chronic great gastritis is a risk Factor For development of gastric dysplasia and adenocarcinoma