Gastric Ulcer

With the recognition of H.Pylori the distinction between DU and GU is blurred

10% of population

male/female     approx. 2:1

Ø     Smoking

Ø     Alcohol

Ø     NSAID’s

Ø     Corticosteroids

 

Mucosal defence V/S  acid pepsin secretion

Ø     Infection with H.pylori

Ø     NSAID

Ø     Acid hypersecretion

Ø     Epigastric pain àinduced by eating

Ø     Afraid to eat àloses weight

Ø     Nausea+Vomitting

Ø     Iron deficiency Anaemia

 

Ø     Endoscopy

Ø     Barium meal

 

Ø     Successful acid lowering operation

Ø     Eradication of H.pylori

Ø     Failure of medical therapy

Ø     Non compliance with medication

Ø     Complications or expectation of complication

Ø     Financial grounds

Ø     Non healing gastric ulcer

Ø     Suspicion of carcinoma

Ø     Unstable vital signs not responding to intensive resuscitation

Ø     Continued bleeding, visible on endoscopy

Ø     Lesions that invariable rebleed

 

Ø     One rebleed in hospital (two rebleed under 60years age)

Ø     Transfusion requirements (volume 4 units in 24 hours > 50 years of age or 6 units in 24 hours < 50 years of age.

Ø     Shortage of whole blood.

 

Ø     Haemorrhage

Ø     Perforation

Ø     Gastric outlet obstruction

Ø     Recurrent ulceration

Ø     Post operative syndromes

Ø     Dumping syndrome

Ø     Diarrhoea

Ø     Alkaline reflux gastritis

Ø     Malabsorption

Ø     Carcinoma of gastric remnant

HOME