Gastric ulcers disease

Treatment of H. Pylori Infection in Gastric Ulcer Disease... 

Helicobacter pylori (H. pylori) is a gram-negative bacterium that is often present in the upper GI tract in people with gastric ulcer disease.42 It has been sug-... 

Consequently, treatment of H. pylori infection may improve the prognosis of people with gastric ulcers and other forms of upper GI distress (dyspepsia, gastroesophageal reflux disease). Patients with clinical signs of ulcers who also test positive for this infection should receive a treatment regimen attempting to eradicate the infection. Successful treatment of an H. pylori infection may reduce or eliminate the need for subsequent antiulcer medications in patients with gastric ulcer disease.42... 

Both acid and pepsin contribute to aggressive factors enabling peptic ulcer disease or reflux erosions. The recent implication of H. pylori in generation of duodenal and gastric ulcer disease has added an additional element for consideration as an aggressive factor that can result in loss of epithelial integrity. 

Gastric ulcer is a mucosal defect that reaches the muscularis mucosa and beyond. Ulcers occur usually in a solitary fashion. Gastric ulcer disease with or without perforation is one of the most important causes of acute abdomen (Fig. 6.2.20 Jacobs et al. 1991). 

The vast majority (90%) of gastric ulcers develop along the lesser curvature or posterior wall of the gastric antrum or body of the stomach. Less than 5% of gastric ulcers occur on the anterior wall. Aspirin, NSAIDs, alcohol, coffee, corticosteroids and stress have been associated with gastric ulcer disease. 

Poor gastric distension may imitate gastritis Gastric ulcer disease... 

Bismudi subsalicylate is used in combination witii otiier dru > to treat gastric and duodenal ulcers caused by H. pylori bacteria Mesalamine is used in the treatment of chronic inflammatoiy bowel disease Misoprostol is used to prevent gastric ulcers in those taking aspirin or nonsteroidal anti-inflammatory dragp in high doses for a prolonged time Olsalazine is used in the treatment of ulcerative colitis in those allergic to sulfasalazine. Sulfasalazine is used in the treatment of Crohn s disease and ulcerative colitis. Sucralfate is used in the treatment of duodenal ulcer. 

Sobala, G.M. and Axon, A.T.R. (1992). Helicobacter pylori, gastric ulceration and the postoperative stomach. In Helicobacter pylori and Gastroduodenal Disease (eds. B.J. Rathbone and R.V. Heatley) pp. 150-157. Blackwell Scientific Publications, Oxford. 

Superior mesenteric artery syndrome Enteric infections Inflammatory bowel diseases Pancreatitis Appendicitis Cholecystitis Biliary colic Gastroparesis Postvagotomy syndrome Intestinal pseudo-obstruction Functional dyspepsia Gastroesophageal reflux Peptic ulcer disease Hepatitis Peritonitis Gastric malignancy Liver failure... 

A 48-year-old man with a history of hypertension, peptic ulcer disease (gastric ulcer 1 year ago), and morbid obesity presents to the emergency department complaining of excruciating pain in his left big toe and both ankles. This is similar to a painful episode he had with his left toe and ankle 6 months ago. On examination, his left great toe and both ankles are red, swollen, and warm to the touch. He describes the pain as throbbing and rates it as a 1 0 of 1 0 (where 1 0 is the worse pain he has ever experienced). He admits to drinking a six-pack of beer on weekends. 

Given the role of H. pylori infection in gastric cancer and duodenal ulcer disease, one must note that certain interleukin-1 gene cluster polymorphisms (suspected of increasing production of interleukin-1-/1) are associated with a predisposition to hypochlorhydria and gastric cancer [52]. One of these host DNA polymorphisms involves a TATA box. 

Helicobacter pylori infections are now also accepted as the primary cause of peptic ulcer disease (PUD). In the US, approximately four to five million people suffer from PUD, and the economic consequences of the disease are responsible for as much as 3 to 4 billion in annual health care costs. The situation is even more serious in many developing countries, where HP infections, PUD and gastric cancer are major causes of morbidity. 

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