Peptic ulcer


 PEPTIC ULCER 


peptic region: It includes lower oesophagus stomach and 1st part of duodenum .


Ulcer: any discountinity of mucous membranes is called ulcer.


Peptic ulcer: any discountinity of mucous membrane of the peptic region is called peptic ulcer.


Causes 

-Idiopathic (थाहाँ नभएको )

-smoking

-H.pyloric

-Spicy oily foods

-Stress 

-Drugs like NSAID 



SYMPTOMS 


-heart burn 

-Aneroxia

-Nausea vomiting

-Abdominal pain

-Water brash 

-Constipation 

-Heamotemesis ( blood vomiting)

-Malena (blood in stool)


Sign (o/e)


-Tenderness in epigastric region(pain feel by pt during touching them by dr.)


- Pointing sign positive (showing pain region by patient by one finger or two finger )


-Muscle guarding(hardness of muscle in epigastric)


INVESTIGATION 


- endoscopy

- Stool for occult in blood - test 

- CBC

    . Total count 

    . Differential count 

- Biopsy 


COMPLICATIONS


- perforation 

- heamorhage 

- peritonitis 

- shock , death 




TREATMENT 


General treatment 

      - Rest 

      - Normal diet 


Symptomatic treatment

  If abdominal pain then use antispasmodic or tab spasmo ( 🆘


Specific treatment 

-Antibiotics like elathromycin


- Triple therapy  

(Note. Triple therapy include PPI and 2 antibiotics )



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