gastritis and pepic ulcer

Gastritis and Peptic Ulcer

Gastritis is an inflammation of the gastric mucosa can be acute, chronic, diffuse or localized. Peptic ulcer  is an area aksoriasi mucosa caused by gastric fluid digestion work

clinical manifestations
• epigastric pain, be pain palpation
• vomiting, nausea, anorexia
• Can hematemisis and melena
• anemis, Hb drops
• Bloating or pletulen

The mechanism of gastric acid secretion
       

 Stimulation of enteric nerve                                             vagus nerve

     

      HCl                                             gastrin                                   parasimpatic nerve

                                                        HCl                                         asetilkolin

 

                    Enteric Refleks                                          histamin

                     

                             

                              HCl  ↑                                         secretion of  HCl ↑↑

management
• Stop the cause / treat the cause
• Fasting to acute pain and nausea was reduced (12-24 hours), then diit liquids and soft foods
• Antacids
• Selective anticholinergic agent (perenzepine)
• H-2 receptor antagonists (cimetidine, ranitidine, famotidine)
• Cytoprotective agent (sucralfate, cetraxate)
• For hemorrhagic gastritis, fasting for up to 24 hours to stop bleeding, NGT to gastric rinse
• Blood transfusion

mechanism

                                      Gastritis

doudenum & gaster iritations    gastric wall erotion           HCl ↑

aferen vagus nerve   antiperistaltik   broken tissue   intrinsic factor     incomplete digention

simpatis nerve                                                                                              food waste ↑↑                            

Pusat muntah      intentinal reflux   bradikinin etc    bleeding      B12 ↓

                                                                                                              Eritrosit ↓ 

vomiting  nausea   duodenal distension   gas    nerve pain

                                                                         Talamus        hematemisis

   anorexia                                                          nyeri                    Hb ↓

                                             Bloating or pletulen                                     bacterial fermentation