When acid in the digestive tract eats away at the inner surface of the stomach or the small intestine, it leads to peptic ulcers. When this happens, it can create painful open sores that might bleed.
Usually the most common cause of ulcers is infection of the stomach by bacteria called Helicobacter pylori and most people who suffer from peptic ulcers have these bacteria living in their digestive tract.
Peptic ulcer disease is one of the most important and recurring topics in Medicine. Read this blog post thoroughly and boost your Medicine preparation for NEET PG.
Type B Gastritis
Warthin Starry Stain
In the following picture black dots represent presence of Helicobacter Pylori
Helicobacter pylori
Leading cause of PUD: Type B gastritis
Gram negative coccobacilli
Non-Sporing: eradication possible
Route of spread: Feco-oral route
Extra Cellular Bacteria / Microaerophilic
Mechanism of action:
Urea
urease
Ammonia (Alkaline)
↓
Irritation of G cells& parietal cell ⊕
↓
Excessive acid production (Hyper chlorhydria)
↓
Ulcer
Duodenal ulcer>Gastric ulcer
Work Up
Screening test → Breath urea test (Non-invasive)
Urease test (Invasive) (CLO TEST- commercial name) → stomach scraping during endoscopy
Type 1: lesser curvature (MC site) near incisura Angularis
D1: Duodenal Cap
First part of duodenum
Pain
Epigastric pain (Immediately after food Intake) weight loss
Epigastric pain "hunger pain" Snacking by patient leads to weight gain
Important Information
H. Pylori is an Extracellular bacterium while Tropheryma whippelei leading to Whipple’s disease is intracellular bacteria found inside macrophages of intestine.
Hamartomatous polyps in jejunum that lead to bleeding, obstruction & intussusception
Mucosal melanosis
Arborizing pattern
Most common site: Jejunum
Increased incidence of Ca stomach / ovary / cervix/ Hepatobiliary cancer
Polyps themselves are not premalignant but a definitive association with both intestinal, hepatobiliary, and extra intestinal malignancy.
And that is everything you need to know about Peptic ulcer Disease for your Medicine preparation. For more interesting and informative blog posts like this, download the PrepLadder App and keep following our blog.
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