Stomach and Duodenum

Stomach € duedenum —Anatomical Fotrochetions: mek * Smosth mascle of atall of Stomach as 3 layers jiaZ Z fundus = onder longitud tach cae 2- franer CicGalac 3 Tone most son Obligue- Thee are 2 sphraders TF Jaslre- esophageal 2- pyloric SPhincter- Histelepical Background % PuGus Secrebing Gls & E Pe Presert Prouspout the stomach & au € secrete Mucous Crnuclas) & brarbond? ees 7 Secretion I's shinulated by frostaglandh'a « Mucosal barrier s. madeup of plasma membranes of maucesel Qu & meus lager that potech gatic epithelium ftom da mage b ac & alchol, aploin, Bile Salts... Be ona)@ Hel Cen, OF stomach» en Co mensic Factor a Pper 2 ‘mach 1- Pacietal Cele PP Ya of stomac 2 ee »> pepsrra? oF 7 ——_——— , ac Moke mace 1. G chy anne gun pethen ~ D-Glls > Secret Somete Hedin > Supper Np come facie secretion: ane Dacca! tures > Cole's B eampec's glands that Seceele Alkaline MuGous . Alkaline mucous + Percreatic +biliny Secaction <> helpto Neuteli ace) Setrtion. P hy stologi G) Jotoduction ‘ A- Phases of acd Secebon .. Just thought 5 sight Smell off Fard 5 Stimulate -Yaqus Necle te feedua accky choline Eactvahion of parietal Qu (2 Gabhic Phaie) Direct clistenss on by food Skonulates Secretory Gil * Pen'etal Cllr & 6 Ch- (2-Titestnd Pac Pasage of Faso) te tedegog: Stimulate Qo hormone [elease-ae) Crt Functions -® picid prea Some Foodborne= ~ Tnfections @ Resectoir of Food F yhiag ° By Emalsifcation of Fe Bm yale Cat jastn'c Col _@ Sxceeton of Totenste Factor Absoptlons ralnal b or bene Gastcif's DPlomakion that asocledec) Glith macasal lajury Ge H-pylon The Cmmonest ule gaskets C 73) @ Piuto omayne gastthis is Sen LAG) G@ other CGuses Gastropathy Epithelial Gl damage & P d Fegearction ultthout Pflanmation > Drugs by NSATO. D Bribeats pein U @ Proctal. Hyperteaston G Poel hypedicasne gettopath) @ Chronic Goagestion Selere Stress (Stes ules) SeCndery to Burne or vauma CNeorte COSNe Nic gastro pathy ) : [fend Felli uremic Sekopath, ) aAuto immune gastritis rect, fundus Pocly of Stomach (peng? leading to atrophic gastritis € Loss of Pars Calls Cachlor hydra) @ Iatreasic factor defecieny sading Fo(Pernicious anemia) Which 1S Commonly ds Sociated with other aatoinamune cliseases a5 thypoicl ee Addison's disease Vilh'g 0 * Serum aub antibodies to gate Peoetal Gls ale Common at Non-specific while Antibodies to intrensic fackr ale leer bat mote Sigatficat ~ Helicolacter Pylori (H-pylod) * Acam —Ve SPieal— shaped > Flagellatcol RBCs) Producing Bacter'um- Mie & 1% Colonies the mucus layer a Jaskc adteam and founded! 10 the Greatest dumbec Under Md@us layer ia gastric Pits obhere jt adheres to Jertec. -€ Pitheltal Cells ¢ Lifection is asually QC4utec In childhood s4 with age + Be rmybe(Re- onl) o«i- “the Prevelang * {afecton tales" are highest wees Come Qroups developing Goudie > go-90% call OF Population 2 much lover 20-90% In deseleP Countries Oooo > (Pathegenesis of H-Pylor +The of anism Cilonit the epithelium z inlgilork= the mucus Layer i Cell * ikadheres on the sufac of Jastcic mucsal Cells by apumber oF @dhesion MoleGTes) expressed On the Surface of gastric mucosal Cle F Guses Gjastrttis % Damage to gastic €p*thelial Gll "8 Gused by. [Release Of Unease ~> leads to Formation of (Grimenia)# (Chloride = Which ae dlivechy Cytoter'e Zeahanc Thduction of # Pathological effects olePends one. @ Vitulene of or an'sm Expression off Teasay 2 {NacA] 24 Taduchion OF It-¢ CPeteat medltator of jof lammation ) A)2 Goletic associated Profein Nacalatiag toxins @ erctic Factors Poly mocphismms Pha ~ ackag to p Izy We AsSociat, J ud} ad, tale, "t), : SPhte gates Cwac fl) * aioe :6 Possible Yesults of Hpylori Safection —— —_ a | Gastric ~Oastric _ Extra - aed ner D Antal gach O Spon, defeciory 20 O Peptic vine am! — @ Ioxrune Hrombotsep o_PePhic ulcers lou grade lymphomas regess Gastric _ 1- Antal gastctis + [he usual effect of H- pyfor: infection (/omal 5 # Chronic antral. gasteitis Gus: iin. ng H astr'nem) atacid Output “ES. Usually ee me bat Cuodlenal alceration) ul@ral Hor) aati aan aclualt oa ¥@n ae tend to Thole the bocly of Stomach + [tm Progress tl Chroni trop hs teitis (Giisnd aeaplansS cq c gar te or aaaGi p} | trfeced -pylori oF Duodenal ulges. vhffedt lo-dor. of H-Pslor fe * ram Bt Timner More Coramon . tric ule NGlor’ associated “th etloping Guntries erin ‘atth D-al@r aie high Hepylor’ Tafection edb a apse “ in devel oPecl Counties NS Recaceace is prevented Tndued peptic ul@-# hy Hpylor eradication @ Surrounding masa ppeacs lof lammed friable “choco factors Inpheded th Dus {- Thcrease atid Section - Decrease ac ~Smoking VGendtic Suucephbilty & Blo dfeup"-o+ BY Gashicukeee «usually at lester Girlatuce Neae Aisa Cat the Tenction betesen atte € Body type’ MUGS) Bat Ep tol Suppression be found! 10 pat x ects I-loy. ‘ Loe areTal Ql out rity. y epletion @ v ae ee maSEE * The ules are thought to occur beGuse of @ lection of gastric Mumsal fesisteaCe dt Feetne Prooluction by Thfection or alterahion OF gust Geastec MuGas atk of maligncacy_ IS More than Dus- Clinical Featues of Pup Ep lastnic Pain +The Charactarestic fature of peptic aller 1S fecarent buming epypattric Palo C Hangar Pain, Night fain , 1c o9 ¥ The (elation s ‘Pp of Pain te Foool Us : © Nok help fal 10 dagnosis a * the Peo OF Du cioseeath oc _ 10a Cars at whe ts dors. uhen pt fog: a ea . % = Impraye boy eating But ts Not valu * oie x The Pan of loath Gu s Qus May be telinecl by Antacids 2 Piisteat ESelete Pain Suggesds CompliGtions such as Peactration Jote other ogaas acl? Pexin Su: gests Peadtratin Poster’or le, we vB Tt Pt iat th sizyle Frager =S'tpest QEEE 2. © —Seisee 2 vomiting Crater tay acconpons PPG, ~ Yomifing is ingrequent Veline “the for ) 2 Hee burn “—Anoetia ¢ ult loss > Pad'caorly ustth Gus D> Hematemesic g Meleda » (flack eppa Gt Plecding SA h No Preceding ular Syphon . 6- Symptoms of Du elapse Ss Remit SPonta.n eously 7- EXamination IE usually on helpful 2 as epigashic fendlesness |S Conmon id both dlecs Nery ulCer oly spepata ConopiliGtions of Ped |- Upper GH bleeding 2- Peforation Bgleric St en05i's “ gastec oudtflony obstruct on” as aresult of healing of ulter Pt has Patnlece Lofreq veat- [7 eJec tile é lardeVolume Noating thet Gateins Particles OF Previous meal x07 Examination of abdomen SSuccussion fy J SPlach : eg flies WP Seveve / Pecsitfent « Diagnosis is Core by Endoscopy Tn be SUpoctocf es lature oF Vom/ttin _ ge tialinan gS eoly I Gar iric @na,eR Ri a perc ic pias fue eie iv Etiologicl factors For pud Other than H-py tor , l \- NSALO:s > Cause clamage of gaste'c muasa ~~ banter matty el, tobthikion oF UT er ly ae , re Prostaglandin loy Sahibitiag Cy OkydNase Ccox-1 practhuay J * Sot of P+ with feguar NSAIDs uli develop (Gastnc ul@r) Aut only smal] pro Portion OF Dus aG 7 * # bie % NSALOs ate Sodepenclant & SWner: eshic [isk factor fer develop meat Of ules. 2- Alchol 2-Zobtrager Ellis on Syodrome 5 rkrackhk Uken Diag nosis OF Pu Lo iene. Decent Presence Oragnos's OF Cute at age OF Ulec 4 \- Enchs cpy Ae Digénasis oF H-Pylor, “HOF Piles Nap 2- Double Contr}. AE eee Stely CBariyy Meal) 3- Zollinger Fl) 5 but [ely Uech, OnMV Anvtesti gations of Sutpected PuD \- Endoscopy 5 {5 required chen Q Presence of Alarming Symptoms ubhafever Se @ flarning Synpboms |= Qysphay iq 2~ ult Loss ” S-Flematemesis iil. @ Older P, > 59 Ys Tequire endos@pi ce dha nosis < ‘ExClus!on OF CanGe- pil gastric lees must be biopsied 4 Exclude Udder Mins or & should be Followed) up Endoscepically und) healing occuce. 2- Patient under 56 Ys of age cdi}, Pical Symptonn a of Peptic ule; "Sease sho Test Prete a. H ~PYlor; ae: Ulb'thout Prichhe bradicatog thera est yack Jongr Lnvestigations For H- pylori Infection @ Non- Srvashe methods R-_ Serological fests bo detect 19 antilades_ aC fibres tray take up to 4 year to Fall by 50% after eradication therapy & therefore Not useful in Conbroning Eradication or Present of Curent Infection B- 13 ¢ - urea breath test Reliable test € Gn be used 25 Stree ning fest lout No Aatibiotic in 4 Jeeles before test No ppl in previous 2 Weelts C- Stool Antigen test adely clailable test ‘Susefal in BM of H: Pylor’ Infection & Sor Montoring efPiacy of eradiG@tion +therap 4 bide No Aobiblolics 4 wece Is before test No— PPL 2 Weeks before test Q) Invasive methods - Biobs , fcoebe | ocibhiny | cat mag be (Giemsa Stained ¥ Used th Pt False ve IF + Sensibvtty Is feduced “ith refractory Pe staking FF pe json ppl H-Pslor: Thfecton PPE oranthatic + less ulth Uae to Hdeatify at thetime test: 0 Propriate antibiotic regimen CReshie Galhare Is)Q Trechment of peptic ulGer disease StoP SMolking ty General measures :. ime Me) ; * Pt wth gastric ulcer Should! be Youtinely re-enelosa Ps CF Wlecks to Confirm mucosal healing @ exc ude Underly ing gastric Cancer ™ fleeat Blobsy may be NeGssary I} Specific Treatment Non-s urgical Treatment Surgical otnent) 1) H- yor etechcation Clater) only ear 2) Aoktacids ec atechNettt Com pli Gcttons AY Drugs that) acid seartion D Deg Heit saat ¥ Ho antagonist Proter NGatolled Nye *HI/k+ Pate i i A hibitors - Peferetion PE Bed eae maser fp oPeFon Tare SFG & lee formed j'9 * Glloid bithous Compounds py a * Sucral pate atiel Jautrechs * Prosteslandin anabgties as . © Vagote MisopProstol paNee H- Pyloré Eradication Tndications of H- Pylon Eradication Gaste'c 9 —Pephic ule dlsease Tajuedenal = gaxtr'e MAT lymphoma 3- T TP s Pe tlith history of peptic alec ore friftads'on of bong term treatment ulith aGtylsak alte acid or Nap 6 - upper GIt hye Under tH whith A&A 0 NsiI Ds 7- Prophylas's agaiart epolic Carcinoma In Pe risk B- larctional dys Peps'a after eSophega -guitee — cluedeno ft @py Some Iimportast Information Reqacdis Eradication Thereepy - * ( mmbination therapy 1s essential Need Compiands, Is ale ee + Combinetion ig available For Tdays uf At Resistnce IY days Yeginnen Is ReComenchecl. * Regimen Usually Compra! % 2 antthiot' cy 7 Poderful acid suppression inthe Porrn of ppr Clacithramycin Resshnte Ato derelped Counties ebhike Metronide tke [essence h'gh 10 oue Counties © IS ettremely % Res'steng to amokicilhig C-e) « Bagchi by Gatrast are SuperFrCl Talks fry muta alone NBe te NsAra, -Tndueg dastropathy Hf =5 Stop NS ATO, C pet ye Caadiction of H-pylor’ Ip We 10 Retest ulho Cot Stop wed of ATO * CoX-2 Selective NSATOs et lower! clos. + Prophylacke Gloprcbect Ne therap ¥ @s Miso Prostol, ¥ PPr

Stomach and Duodenum

Uploaded by

Copyright:

Available Formats

Stomach and Duodenum

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Stomach and Duodenum

Uploaded by

Copyright:

Available Formats

You might also like