Pregnancy, obesity, food and drinks and drugs that irritate mucosal lining (aspirin, NSAIDs, potassiumchloride)
Role of NSAIDs in PUD
Inhibit synthesis of prostaglandins by inhibiting cyclo-oxygenase (COX), reducing production of protectiveprostaglandins and making stomach lining more vulnerable to damage from gastric acid
Role of H. pylori in PUD
Weakensprotectivemucous coating of the stomach and duodenum, acid and H Pylori irritate lining causing ulcer
H. pylori eradication
1. Treatment with combination of antibiotics and acid-suppressing medications (protonpumpinhibitor, amoxicillin, clarithromycin)
2. Follow-up test to confirm bacteria eliminated
Antacids
Neutralize stomach acid to relieve heartburn and indigestion, but can cause constipation or diarrhea
H2 receptor antagonists
Reduce stomach acid production and can lead to mild side effects like headache
Proton pump inhibitors
Block acid production more effectively, relieving symptoms and promoting ulcer healing, but long-term use may increase risk of fractures and infections
Management of GORD
1. Elevate head of bed
2. Avoid eating within 2-3 hours of bed
3. Lose weight
4. Stop smoking
5. Reduce alcohol
6. Modify diet
7. Use antacids, H2 receptors, PPIs
Management of PUD
1. Stop drug inducing PUD (NSAID)
2. Use misoprostol and sucralfate (protective agents)
3. Eradicate H. pylori
4. Use antacids, PPIs, clarithromycin, amoxicillin
