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Gastrointestinal

Terms in this set (17)

A group of disorders affecting the upper GIT: duodenal ulcers (DU), gastric ulcers (GU), esophageal ulcers, hypersecretory states (Zollinger-Ellison syndrome (ZES))
Peptic ulcer disease
Protective mechanism of a mucous cell
Secretion of mucus and bicarbonate forms a physiochemical barrier that
Cytoprotective actions of prostaglandins (PGs) (4)
1. stimulate mucus and bicarbonate secretion
2. enhance mucosal blood flow
3. reduce back-diffusion of hydrogen ions
4. enhance cell turnover
2nd-most common cause of PUD
chronic use of NSAIDs
Effects of chronic NSAID use
1. localized, topical injury to surface epithelium
2. suppression of GI mucosal prostaglandin production
3. erosive gastropathy
Most common cause of PUD
H. pylori infection
Etiology of H. pylori infection with PUD
Antral infection releases inflammatory mediators that move downstream and injure duodenal mucosa; local inflammatory response
Urease which generates free ammonia; neutrophils secrete hypochlorous acid (HOCl) which reacts with ammonia to form monochloramine
mechanism involving H. pylori secretions
Protease which degrades glycoproteins in the mucus and decreases mucus viscosity
mechanism involving H. pylori secretions
Platelet-activating factor (PAF): promotes thrombotic occlusion of surface capillaries
mechanism involving H. pylori secretions
Lipopolysaccharide: recruits inflammatory cells; chronically inflamed mucosa is more susceptible to acid-induced injury
mechanism involving H. pylori secretions
Major risk factors for PUD
1) inflammatory response to H. pylori infection
2) chronic use of NSAIDs
3) cigarette smoking increases he risk for development and recurrence of PUD
4) corticosteroids: when used in combination with NSAIDs
Drug treatment for PUD that neutralizes gastric acid
antacids
Drug treatment for PUD inhibition of acid secretion
histamine-2 receptor antagonists, proton pump inhibitors
Drug treatment for PUD protection of gastric and duodenal mucose
sucralfate
Drug treatment for PUD eradication of H. pylori infection
antibacterial regimens
Positive testing indicates a 7-14 day regimen of antimicrobials and acid-suppressive therapy
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