1. PEPTIC ULCERS Gastroenterology University of Pretoria
Pretoria Academic Hospital
Obedy Mwantembe
04 May, 2004
11/8/2018

2. Definition – Peptic Ulcer
An ulcer in the
Lower oesophagus
Stomach
Duodenum
Acute or Chronic
11/8/2018

3. Ulcer or Erosion Muscularis Mucosae Duodenal Ulcer Oesophageal ulcers
Small bowel ulcers
11/8/2018

4. Epideomiology
Up to 10-12% in one’s life time
11/8/2018

5. Duodenal Ulcer
Male:Female 5-2:1
90% H.pyroli
11/8/2018

6. Gastric Ulcer
Male:Female 2:1
Up to 70% h. pyroli
11/8/2018

7. AETIOLOGY Helicobacter Pyroli
Age 12 nearly 100%
Europe 30-40%
DU – 90%
GU – 70%
Non-Steroidal anti-inflammatory drugs (NSAIDs)
Inhibit cyclo-oxygenase activity
Reduce formation of protective PGE
11/8/2018

8. AETIOLOGY Heredity Smoking Stress ulcers
DU closer than GU especially if below 20y
Blood Group O
Smoking
GU than DU
Difficult healing
Stress ulcers
11/8/2018

9. AETIOLOGY Acid-pepsin and acid Vs
Defensive factors (Gastric mucosal barrier)
No ulcer No acid (Pernicious Anaemia)
Too much acid – severe ulcerations
11/8/2018

10. CHRONIC ULCER
90% in lesser curve within antrum or at junction between body and antral mucosa (stomach)
Duodenal ulcers
1st part
50% anterior wall
11/8/2018

11. THE CLINIC Recurrent abdominal pain
Epigastrium
Related to food
Episodic
History a questionable indicator of the presence of an ulcer
11/8/2018

12. 11/8/2018

13. 11/8/2018

14. 11/8/2018

15. 11/8/2018

16. 11/8/2018

17. 11/8/2018

18. 11/8/2018

19. 11/8/2018

20. Topics of Discussion State the main ideas you’ll be talking about
11/8/2018

21. Topic One Details about this topic Supporting information and examples
How it relates to your audience
11/8/2018

22. Topic Two Details about this topic Supporting information and examples
How it relates to your audience
11/8/2018

23. Topic Three Details about this topic
Supporting information and examples
How it relates to your audience
11/8/2018

24. Real Life Give an example or real life anecdote
Sympathize with the audience’s situation if appropriate
11/8/2018

25. What This Means
Add a strong statement that summarizes how you feel or think about this topic
Summarize key points you want your audience to remember
11/8/2018

26. Next Steps Summarize any actions required of your audience
Summarize any follow up action items required of you
11/8/2018