GASTRIC ULCER

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Maghrifah Akriani Fifti

Nafla Rintisa
Ni Luh Esti Listiani
Ni Nengah Pini Sriani
Nurhidayati
Yohana Septa Putri

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Key Words

A 52-year-old man
upper abdominal pain 2 weeks
heartburn and nausea
no vomiting or diarrhea
his stool looks darker
not seen any blood
feels full quickly after eating
taking some over-the-counter antacid
an over-the-counter nonsteroidal anti-inflammatory
drug (NSAID)

once or twice a day because of arthritis in his

knees.
not smoke cigarettes or drink alcohol
pale appearing
he is afebrile,blood pressure is 120/80 mm
Hg,pulse is 95 beats/min, and respiratory rate is
14 breaths/min.
Head, eyes, ears, nose, and throat (HEENT)
examination is notable only for pale
conjunctiva.
tenderness in the epigastrium.
dark black stool that is strongly fecal occult
blood test (FOBT) positive.

Definition
Gastric ulcer is an open wound in the
side of edema with induration ulcer base
covered with debris.
Gastric ulcers are sores in the lining of
the stomach . Gastric ulcers can be treated
.A small portion of these ulcers may
become cancerous.

Epidemiology

In the United States , peptic ulcer disease

( PUD ) affects about 4.5 million people
each year with 20 % caused by
Helicobacter pylori . Prevalence of gastric
ulcers in men is 11-14 % , and the
prevalence in women is 8-11%.

Etiology
According to Sam LK ( 1994 ) there are
several factors etiology of gastric ulcers
that Helicobacter pylori infection , NSAID
use , smoking, and habits food .

1. Helicobacter pylori
It has long been known to have a
relationship with gastric ulcer infection
germs Helicobacter pylori

2. NSAID
The use of these drugs interfere with infiltration
of the mucosa, destroying the mucosal and cause
mucosal damage 30% of adults who use NSAIDs
have adverse GI .
3. Genetic
More than 20 % of patients have a family history
of gastric ulcers.
4. Additional etiologic factors
In addition , one rather than the disease may be
related to gastric ulcersie liver cirrhosis , chronic
obstructive pulmonary disease and autoimmune
diseases.

Symptoms

Symptoms depend on the location and age of

ulcer patients , especially patientselderly
often have little or no symptoms . Pain is the
most common often in the form of epigastric
pain and reduced in the presence of food
oradministration of antacids . The pain may
be burning, or sometimes as the sensation of
hunger . The pain is usually chronic and
recurrent . only abouthalf of the patients
present with symptoms typical .

Classification
By Region/Location :
1. Stomach
2. Duodenum
3. Esophagus
4. Meckels Diverticulum

Pathogenesis
Duodenal ulcers are different with gastric ulcers:
Duodenal ulcers and gastric acid plays a role in
the increase of HCl and the stimulation of the
basal state or after a meal.

Gastric ulcer is more important mucosal

defense ( defensive factors ) ; include gastric
motility disorders that cause reflux of bile from
the duodenum into the stomach , slowing
gastric emptying

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HELICOBACTER PYLORI
Non Steroidal Anti-inflammatory Drugs
Steroid therapy
Smoking
Excess alcohol intake
Genetic factors
Zollinger Ellison syndrome rare syndrome
caused by gastrin-secreting tumour
Blood group O
Hyperparathyroidism
sex is a man of many exposed gastric ulcerlow
socio economic status

Treatment
1. Antacids
2. The management of diet, by eating a little bit but
with a high frequency (often), to neutralize
excess acid in peptic ulcer.
3. Anticholinergic, inhibiti the parasympathetic
postganglionic nerves that secrete achetilcholine.
However, this drug is rarely used due to other
effects that are less favorable hull, which would
inhibit the motility of the intestine alone will
result in slowing of gastric emptying alone.

4. Inhibiting H2 (Histamine) because effects

of histamine stimulates acid secretion /
HCl and pepsinogen. Preparations used
were cimetidine, ranitidine, and famotidin
5. Antimicroba / anti-bacterial, for example,
if the presence of Helicobacter pylori
infection.
6. Get plenty of rest, both physically and
emotionally