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Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Benign liver tumors
Cholestatic liver disease
Non-alcoholic fatty liver disease
Primary biliary cirrhosis
Primary sclerosing cholangitis
Pancreatic neuroendocrine neoplasms
Familial adenomatous polyposis
Juvenile polyposis syndrome
Small bowel ischemia and infarction
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Diverticulosis and diverticulitis
Irritable bowel syndrome
Cleft lip and palate
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Cyclic vomiting syndrome
Gastric dumping syndrome
Dental caries disease
Gingivitis and periodontitis
Temporomandibular joint dysfunction
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
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0 / 7 complete
Peptic Ulcer Disease Assessment
Peptic Ulcer Disease Interventions
Acute and Chronic Gastritis & Peptic Ulcer Disease
peptic ulcer disease p. 387
acute gastric ulcer p. 734
NSAID toxicity p. 495
gastric ulcers from p. 387
peptic ulcer disease and p. 387
associations p. 727
glycopyrrolate for p. 240
H2 blockers for p. 405
Helicobacter pylori p. , 144
misoprostol for p. 406
proton pump inhibitors for p. 405
Zollinger-Ellison syndrome p. 357
duodenal ulcer p. 371
gastric ulcers p. 387
Peptic refers to the stomach, and an ulcer is a sore or break in a membrane, so peptic ulcer disease describes having one or more sores in the stomach - called gastric ulcers - or duodenum - called duodenal ulcers- which are actually more common.
Normally, the inner wall of the entire gastrointestinal tract is lined with mucosa, which has three cell layers.
The innermost layer is the epithelial layer and it absorbs and secretes mucus and digestive enzymes.
The middle layer is the lamina propria and it contains blood and lymph vessels.
Then there’s the outermost layer which is the muscularis mucosa, and it’s a layer of smooth muscle that contracts and helps break down food.
In the stomach, there are four regions - the cardia, the fundus, the body, and the antrum.
So the epithelial layer in different parts of the stomach contains different proportions of gastric glands which secrete various substances.
Having said that, the cardia contains mostly foveolar cells that secrete mucus which is a mix of water and glycoproteins.
The fundus and the body have mostly parietal cells that secrete hydrochloric acid and chief cells that secrete pepsinogen, an enzyme that digests protein.
Finally, the antrum has mostly G cells that secrete gastrin in response to food entering the stomach. These G cells are also found in the duodenum and the pancreas, which is an accessory organ of the gastrointestinal tract.
Gastrin stimulates the parietal cells to secrete hydrochloric acid, and more broadly stimulates the growth of glands throughout the stomach.
In addition, the duodenum contains Brunner glands which secrete mucus rich in bicarbonate ions.
In fact, with all of the digestive enzymes and hydrochloric acid floating around, the stomach and duodenal mucosa would get digested if not for the mucus coating the walls and bicarbonate ions secreted by the duodenum which neutralizes the acid.
A peptic ulcer is an erosion or a break in gastric or/and duodenal mucosa. The most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Symptoms of a peptic ulcer include abdominal pain, usually felt in the upper middle or upper left part of the abdomen, bloating, vomiting, nausea, and loss of appetite. In severe cases, a peptic ulcer can cause bleeding or a perforation in the mucosa of the stomach or duodenum. Treatment includes a combination of medications called triple therapy to kill the H. pylori bacteria and reduce acid production in the stomach. Surgery is the last optional treatment to repair the ulcer if drugs are unsuccessful.
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