Gastric Ulcer
đš āĻā§āϝāĻžāϏā§āĻā§āϰāĻŋāĻ āĻāϞāϏāĻžāϰ āĻā§?
āĻā§āϝāĻžāϏā§āĻā§āϰāĻŋāĻ āĻāϞāϏāĻžāϰ āĻšāϞ⧠āĻĒāĻžāĻāϏā§āĻĨāϞā§āϰ (stomach) āĻā§āϤāϰā§āϰ āĻāĻŦāϰāĻŖā§ (mucosa) āϤā§āϰāĻŋ āĻšāĻā§āĻž āĻāĻāĻāĻŋ āĻā§āώāϤ āĻŦāĻž āĻāĻžāĨ¤ āĻāĻāĻŋ āĻŽā§āϞāϤ Peptic Ulcer Disease-āĻāϰ āĻāĻāĻāĻŋ āĻ āĻāĻļāĨ¤
đš āĻāĻžāϰāĻŖ (Etiology)
āĻā§āϝāĻžāϏā§āĻā§āϰāĻŋāĻ āĻāϞāϏāĻžāϰā§āϰ āĻĒā§āϰāϧāĻžāύ āĻāĻžāϰāĻŖāĻā§āϞ⧠āĻšāϞā§â1. Helicobacter pylori āϏāĻāĻā§āϰāĻŽāĻŖ â āϏāĻŦāĻā§ā§ā§ āϏāĻžāϧāĻžāϰāĻŖ āĻāĻžāϰāĻŖ
2. āĻŦā§āϝāĻĨāĻžāύāĻžāĻļāĻ āĻāώā§āϧ (NSAIDs) āϝā§āĻŽāύ
Ibuprofen
Aspirin
3. āĻ āϤāĻŋāϰāĻŋāĻā§āϤ āĻ ā§āϝāĻžāϏāĻŋāĻĄ āϏāĻŋāĻā§āϰāĻŋāĻļāύ
4. āϧā§āĻŽāĻĒāĻžāύ āĻ āĻ ā§āϝāĻžāϞāĻā§āĻšāϞ
5. āĻŽāĻžāύāϏāĻŋāĻ āĻāĻžāĻĒ (stress)
6. āĻ āύāĻŋā§āĻŽāĻŋāϤ āĻāĻžāĻĻā§āϝāĻžāĻā§āϝāĻžāϏ
đš āϰā§āĻā§āϰ āĻĒā§āϝāĻžāĻĨā§āĻĢāĻŋāĻāĻŋāĻāϞāĻāĻŋ (Pathogenesis)
āĻĒāĻžāĻāϏā§āĻĨāϞā§āϤ⧠acid āĻ pepsin āĻāϰ āĻā§āώāϤāĻŋāĻāϰ āĻĒā§āϰāĻāĻžāĻŦ āĻāĻŦāĻ mucosal protection āĻāĻŽā§ āĻā§āϞ⧠āĻāϞāϏāĻžāϰ āϤā§āϰāĻŋ āĻšā§āĨ¤ âĄī¸ âAggressive factorsâ > âDefensive factorsâ â ulcerđš āĻāĻĒāϏāϰā§āĻ (Symptoms)
āĻĒā§āĻā§āϰ āĻāĻĒāϰāĻŋāĻāĻžāĻā§ āĻā§āĻŦāĻžāϞāĻž āĻŦāĻž āĻŦā§āϝāĻĨāĻž (epigastric pain)
āĻāĻžāĻā§āĻžāϰ āĻĒāϰ āĻŦā§āϝāĻĨāĻž āĻŦā§ā§ā§ āϝāĻžā§ (gastric ulcer-āĻāϰ āĻā§āώā§āϤā§āϰā§)
āĻŦāĻŽāĻŋ āĻāĻžāĻŦ āĻŦāĻž āĻŦāĻŽāĻŋ
āĻāĻāύ āĻāĻŽā§ āϝāĻžāĻā§āĻž
āϰāĻā§āϤāĻā§āώāϰāĻŖ (hematemesis / melena)
đš āĻāĻāĻŋāϞāϤāĻž (Complications)
1. āϰāĻā§āϤāĻā§āώāϰāĻŖ (Bleeding)
2. āĻĒāĻžāϰāĻĢā§āϰā§āĻļāύ (Perforation) â acute abdomen
3. āĻā§āϝāĻžāϏā§āĻā§āϰāĻŋāĻ āĻāĻāĻāϞā§āĻ āĻ āĻŦāϏā§āĻā§āϰāĻžāĻāĻļāύ (GOO)
4. āĻŽā§āϝāĻžāϞāĻŋāĻāύā§āϝāĻžāύā§āϏāĻŋ (Cancer) â gastric ulcer-āĻ malignancy āĻšāĻā§āĻžāϰ āϏāĻŽā§āĻāĻžāĻŦāύāĻž āĻĨāĻžāĻā§
đš āϰā§āĻ āύāĻŋāϰā§āĻŖā§ (Diagnosis)
1. Upper GI Endoscopy â āϏāĻŦāĻā§ā§ā§ āĻā§āϰā§āϤā§āĻŦāĻĒā§āϰā§āĻŖ
2. H. pylori test
--Urea breath test
--Biopsy
3. CBC (anaemia āĻĻā§āĻāĻžāϰ āĻāύā§āϝ)
đš āĻāĻŋāĻāĻŋā§āϏāĻž (Treatment)
đĸ āĻŽā§āĻĄāĻŋāĻā§āϝāĻžāϞ āĻāĻŋāĻāĻŋā§āϏāĻž:
Proton Pump Inhibitor (PPI) āϝā§āĻŽāύ Omeprazole
H. pylori eradication therapy (Triple therapy)
Antacid
đĸ āϏāĻžāϰā§āĻāĻŋāĻā§āϝāĻžāϞ āĻāĻŋāĻāĻŋā§āϏāĻž (Complicated cases): Perforation â Emergency surgery Bleeding uncontrolled â surgery / endoscopic control Suspicion of malignancy â gastrectomyđš āĻĄāĻžā§ā§āĻ āĻ āϞāĻžāĻāĻĢāϏā§āĻāĻžāĻāϞ
āĻāĻžāϞ, āĻŽāĻļāϞāĻžāϝā§āĻā§āϤ āĻāĻžāĻŦāĻžāϰ āĻā§āĻŋā§ā§ āĻāϞāĻž
āϧā§āĻŽāĻĒāĻžāύ āĻ āĻ ā§āϝāĻžāϞāĻā§āĻšāϞ āĻŦāύā§āϧ
āύāĻŋā§āĻŽāĻŋāϤ āĻāĻžāĻŦāĻžāϰ āĻā§āϰāĻšāĻŖ
Stress control