Gastrointestinal Health and Smoking Habits
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Questions and Answers

What is a potential complication of using Diclofenac to induce birth?

  • Fetal brain damage (correct)
  • Uterine rupture (correct)
  • Cervical ripening
  • All of the above
  • What is a non-pharmacological factor that can delay ulcer healing?

  • Smoking (correct)
  • Lack of exercise
  • Drinking
  • Stress
  • What is a common symptom experienced by patients after eradication therapy?

  • Headache
  • Abdominal pain (correct)
  • Fatigue
  • Chest pain
  • What is a medication that should be avoided in patients sensitive to penicillin?

    <p>Amoxicillin</p> Signup and view all the answers

    What is the primary goal of patient monitoring in PUD?

    <p>Symptom control</p> Signup and view all the answers

    What is a potential consequence of taking anticholinergics, TCAs, and calcium channel blockers?

    <p>Lower oesophageal sphincter tone</p> Signup and view all the answers

    What is a future treatment option for peptic ulcer disease?

    <p>Immunization against H. pylori</p> Signup and view all the answers

    What is a warning that patients should be given before starting NSAID or aspirin therapy?

    <p>Risk of gastrointestinal toxicity</p> Signup and view all the answers

    What is a treatment that may be prescribed to anaemic patients following bleeding ulcer?

    <p>Iron therapy</p> Signup and view all the answers

    What is an important instruction that patients receiving eradication therapy should be given?

    <p>Take a combination of 3 drugs for a short period</p> Signup and view all the answers

    Study Notes

    Peptic Ulcer Disease

    • Peptic ulcer disease is a condition where the digestive tract does not follow the one-way rule, leading to gastric ulcer and oesophagitis.
    • In-coordination of nerves can lead to relaxation of the pylorus, allowing bile into the stomach, causing gastric ulcer.
    • Vagus nerve stimulates excessive acid secretion, leading to increased acid secretion.
    • Factors contributing to increased acid secretion include:
      • Nerve stimulation
      • Local factors (diseases of the stomach or diet)
      • Hormonal factors (tumors of the thyroid, pancreas, and adrenal glands)
    • Other causes of peptic ulcer disease include:
      • Long-term use of NSAIDs
      • Infection by gram-negative bacteria (Helicobacter pylori)

    Pathogenesis

    • Two common forms of peptic ulcer disease:
      • Those associated with H. pylori
      • Those associated with the use of NSAIDs
    • Patients may present with signs and symptoms ranging from benign to serious complications, including:
      • GI bleeding
      • Pyloric stenosis

    Clinical Manifestations

    • Upper abdominal pain
    • Anorexia, weight loss, nausea, vomiting, and heartburn
    • Complications:
      • Haemorrhage
      • Anemia
      • Pyloric stenosis
    • Relapse can be reduced by eradication of H. pylori

    Patient Assessment and Diagnosis

    • Endoscopy
    • Radiology
    • Urea Breath Test

    Complications of Peptic Ulcer

    • Bleeding peptic ulcer
    • Pyloric stenosis
    • Late complications of peptic ulcer surgery

    Management of Peptic Ulcer

    • Key elements for successful management:
      • Helicobacter pylori eradication
      • Discontinuation of NSAIDs
    • Treatment options:
      • Proton pump inhibitors (PPIs)
      • H2-receptor antagonists
      • Misoprostol
      • Sucralfate

    Gastro-Esophageal Reflux Disease (GERD)

    • Defined as any symptomatic clinical condition or histopathological alteration resulting from episodes of acid reflux, pepsin, and occasionally bile into the oesophagus from the stomach.
    • Characteristic symptom: heartburn
    • Mechanism of acid reflux is multifactorial, including:
      • Reduced tone of the lower oesophageal sphincter
    • Treatment:
      • Standard dose of PPI therapy
      • Long-term management: least expensive but effective drug

    Prevention of Peptic Ulcer

    • Approaches to help prevent drug-induced upper GI ulceration:
      • Aspirin: use lowest possible dose, avoid other ulcerogenic medications, and use acetaminophen instead of aspirin for osteoarthritis in elderly patients.
      • Bisphosphonates: take with 8 oz of water, remain upright for 30 min after taking medication.
      • Corticosteroids: avoid concomitant use of NSAIDs or aspirin, if possible.
      • NSAIDs: use lowest possible dose, use least ulcerogenic NSAIDs, consider addition of PPI or misoprostol, and avoid other ulcerogenic medications.
      • Potassium chloride: microencapsulated formulation preferred, avoid slow-release wax-matrix formulations.
      • SSRIs: use alternative class of antidepressants, avoid concomitant use of NSAIDs if possible.
      • Tetracyclines: use tablet formulation rather than capsule formulation.

    Future Treatment

    • Immunization against H. pylori will be a future option in the management of peptic ulcer disease.

    Patient Care

    • Patient education:
      • Smoking delays ulcer healing
      • Anticholinergics, TCAs, and calcium channel blockers can delay ulcer healing
    • Patient monitoring:
      • Treatment success in PUD is measured by review of the patient in terms of symptom control.
      • Patients should be warned of GIT risk before beginning NSAID or aspirin therapy.
      • Patients sensitive to penicillin need an alternative to amoxicillin.
      • Anaemic patients following bleeding ulcer are prescribed iron therapy.
      • Patients receiving eradication therapy should be advised of the need for a combination of 3 drugs for a short period of time.

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    Related Documents

    Peptic Ulcer Masters 2024 PDF

    Description

    Quiz about the effects of smoking on gastrointestinal health, including peptic ulcer and gastroesophageal reflux. Learn about the etiology and symptoms of these conditions.

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