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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSPEPTIC ULCER – GASTRIC AND DUODENAL

PEPTIC ULCER – GASTRIC AND DUODENAL

Content

Peptic Ulcer – Gastric and Duodenal

  • Definition: A peptic ulcer is a break in the inner lining of the stomach or the first part of the small intestine (duodenum).
  • Types:
    • Gastric Ulcer: A gastric ulcer occurs in the stomach lining.
    • Duodenal Ulcer: A duodenal ulcer occurs in the first part of the small intestine (duodenum).

Pathophysiology

  • Mucosal Defense: The stomach lining has a mucous layer that protects it from the acidic digestive enzymes.
  • Acid and Pepsin: The stomach secretes hydrochloric acid and pepsin, which break down food.
  • Overproduction of acid and pepsin can lead to peptic ulcers.

Etiological Factors

  • H. Pylori: A type of bacteria that can cause peptic ulcers.
  • NSAIDs: Nonsteroidal anti-inflammatory drugs can cause peptic ulcers.
  • Stress: Physical or emotional stress can cause peptic ulcers.
  • Smoking: Smoking can increase the risk of peptic ulcers.

Clinical Features

  • Abdominal Pain: Pain in the upper abdomen that worsens after eating.
  • Nausea and Vomiting: Feeling queasy or vomiting blood.
  • Loss of Appetite: Loss of interest in food.
  • Weight Loss: Unintentional weight loss.
  • Complications:
    • Bleeding: Ulcers can bleed, leading to anemia.
    • Perforation: Ulcers can perforate, leading to peritonitis.
    • Obstruction: Ulcers can block the flow of food.

Diagnostic Investigations

  • Upper GI Endoscopy: A procedure to visually examine the stomach and duodenum.
  • Biopsy: A sample of tissue is taken for examination.
  • H. Pylori Tests: Blood tests or breath tests to detect H. pylori bacteria.

Endoscopic Findings

  • Gastric Ulcer: A crater-like hole in the stomach lining.
  • Duodenal Ulcer: A crater-like hole in the duodenum.

Indications for Surgical Intervention

  • Bleeding: Surgery to stop the bleeding.
  • Perforation: Surgery to repair the perforation.
  • Obstruction: Surgery to remove the blockage.

Preventive Strategies and Lifestyle Modifications

  • Avoid NSAIDs: Stop taking NSAIDs.
  • Quit Smoking: Quit smoking.
  • Stress Management: Practice stress-reducing techniques.
  • Healthy Diet: Eat a balanced diet.
  • Regular Check-ups: Regular check-ups with a doctor.

Homoeopathic Therapeutic Medicines

  • Nux Vomica: For abdominal pain and nausea.
  • Pulsatilla: For loss of appetite and weight loss.
  • China Officinale: For bleeding and anemia.
  • Lachesis: For stomach pain and bloating.
  • Ipecac: For nausea and vomiting.

Patient Counseling

  • Explain the importance of avoiding NSAIDs.
  • Encourage quitting smoking.
  • Discuss stress-reducing techniques.
  • Advise on a healthy diet.
  • Emphasize the need for regular check-ups.

Lifestyle Modifications

  • Eat smaller, more frequent meals.
  • Avoid spicy or fatty foods.
  • Stay hydrated.
  • Get enough sleep.
  • Practice relaxation techniques.

Homoeopathic Therapeutic Medicines

  • Nux Vomica: For abdominal pain and nausea.
  • Pulsatilla: For loss of appetite and weight loss.
  • China Officinale: For bleeding and anemia.
  • Lachesis: For stomach pain and bloating.
  • Ipecac: For nausea and vomiting.