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Transcript
Internal Medicine
•
ο
Prostaglandins,
ο
Mucus
ο
Bicarbonates
ο
Mucosal blood flow
Aggressive factors
ο
Pepsin
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Hydrochloric acid.
Whereas acid-peptic injury is necessary for ulcer to develop, acid secretion is normal in
almost all patients with gastric ulcers and increased in approximately a third of patients with
duodenal ulcers.
Clinical presentations
• Manifestations are dependent on ulcer location and patient age.
• Course is usually chronic and recurrent.
• Pain is the most common symptom, and described as burning, gnawing or felt as
hunger, often localized to epigastrium and relieved by food or antacids
Gastric ulcer
• Symptoms often do not follow a consistent pattern, especially when ulcer is located in
pyloric channel, where symptoms of obstruction may predominate (bloating, nausea,
vomiting due to edema and scarring).
Duodenal ulcer
• Pain tends to be consistent, usually absent when patient wakes up but appears in
midmorning, and relieved by food but recurs again 2 - 3 hours after a meal.
• Pain may be severe enough to awaken patient at night.
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