• ULCER-----An open sore on an external or internal surface of the

body, caused by a break in the skin or mucous membrane which fails

to heal.
• Ulcers range from small, painful sores in the mouth to bedsores and
serious lesions of the stomach or intestine.
• Dyspepsia- indigestion, discomfort in the upper digestive tract.
• Peptic ulcers are open sores that develop on the inside lining of your
stomach and the upper portion of your small intestine. The most
common symptom of a peptic ulcer is stomach pain.
• Peptic ulcers include:
• Gastric ulcers that occur on the inside of the stomach
• Duodenal ulcers that occur on the inside of the upper portion of your
small intestine (duodenum)
• The most common causes of peptic ulcers are infection with the
bacterium Helicobacter pylori (H. pylori) and long-term use of
nonsteroidal anti-inflammatory drugs (NSAIDs)
• Mechanism of ulcer formation
• Mucous layer
• Prostaglandin,urogastrone\
• epidermal healing factor
• The prostaglandins are a group of lipids made at sites of tissue
damage or infection that are involved in dealing with injury and
illness. They control processes such as inflammation, blood flow, the
formation of blood clots and the induction of labour.
• They are derived enzymatically from the fatty acid arachidonic acid.
• Prostaglandins are powerful, locally-acting vasodilators and inhibit
the aggregation of blood platelets.
• gastrointestinal hormones
• secretin, gastrin, cholecystokinin, enterogastrone,
pancreozymin, urogastrone, enterocrinin, anthelone, villikinin
(Greengard, 1948), motilin (Hallion, 1904), and incretin (La Barre,
1932).
• UROGASTRONE
• Inhibit gastric acid secretion
• Stimulating cell proliferation
• Factors that influence mucosal ability to withstand destructive action
• Integrity of mucosal cell
• Ability of epithelial cell to regenerate themselves
• Mucosal barrier
• blood supply
Causes
• Bacterial infection is the primary cause of peptic ulcers.
• The bacterium Helicobacter pylori(H. pylori) is present in more than 90% of
duodenal ulcers and about 80% of stomach ulcers.
• Genetic factors
• Sex
• Age-20-40
• Stress
• Irritant substances
• High fibre diet
• injury
• Symptoms
• Burning stomach pain
• Feeling of fullness, bloating or belching
• Intolerance to fatty foods
• Heartburn
• Nausea
• The most common peptic ulcer symptom is burning stomach pain. Stomach acid
makes the pain worse, as does having an empty stomach. The pain can often be
relieved by eating certain foods that buffer stomach acid or by taking an
acid-reducing medication, but then it may come back. The pain may be worse
between meals and at night.
• Vomiting or vomiting blood — which may appear red or black
• Dark blood in stools, or stools that are black or tarry
• Trouble breathing
• Feeling faint
• Nausea or vomiting
• Unexplained weight loss
• Appetite changes
Complications

• Left untreated, peptic ulcers can result in:

• Internal bleeding. Bleeding can occur as slow blood loss that leads to
anemia or as severe blood loss that may require hospitalization or a blood
transfusion. Severe blood loss may cause black or bloody vomit or black or
bloody stools.
• A hole (perforation) in stomach wall. Peptic ulcers can develop a hole
through (perforate) the wall of the stomach or small intestine, -----risk of
serious infection of your abdominal cavity (peritonitis).
• Obstruction. Peptic ulcers can block passage of food through the digestive
tract, causing to become full easily, to vomit and to lose weight either
through swelling from inflammation or through scarring.
• Gastric cancer. Studies have shown that people infected with H. pylori have
an increased risk of gastric cancer.
• Prevention
• Protect from infections. ----H. pylori ---it could be transmitted from
person to person or through food and water.
• , by frequently washing your hands with soap and water and by
eating foods that have been cooked completely.
• Use caution with pain relievers. Use of pain relievers that increase
the risk of peptic ulcer,
INFLAMMATORY BOWL DISEASE
• CROHN’sdisease and ulcerative colitis
• What is Ulcerative Colitis
• Ulcerative colitis is a type of inflammatory bowel disease (IBD) which
is characterized by long-term inflammation and ulceration in the
gastrointestinal tract which mainly affects the mucosal lining of the
large intestine (colon) and rectum.
• Inflammatory bowel disease (IBD) is an ongoing inflammatory
condition which affects the intestines. It has 3 subtypes known
as Crohn’s disease, Ulcerative colitis, and indeterminate colitis.
Diseased intestines will be swollen, reddened and less functional,
resulting in a reduction of the overall effectiveness of digestion.
• Constipation
• Constipation occurs when bowel movements become less frequent
and stools become difficult to pass. It happens most often due to
changes in diet or routine, or due to inadequate intake of fiber
• key features that usually define constipation include:
• stools are dry and hard.
• bowel movement is painful and stools are difficult to pass.
• have a feeling that you have not fully emptied your bow
 Irritable bowel syndrome Vs inflammatory
bowel syndrome

The main difference between IBD and

IBS is that IBD is a chronic
inflammatory condition whereas IBS is
a non-inflammatory type of disease.
• What is IBS
• Irritable bowel syndrome (IBS) is defined as a functional disorder which is
caused without any identifiable etiology and characterized by vague
gastrointestinal symptoms such as abdominal pain, cramps, constipation,
and diarrhea. These patients will also complain of increased frequency of
loose stools normal in volume, yet associated with a pain in the right lower
abdomen.
• chronic constipation and severe pain. Depending on the predominance of
symptoms, IBS can be categorized as constipation-predominant,
diarrhea-predominant, or pain-predominant.
• One notable and characteristic feature of IBS include the relationship it has
with stress; acute stressful events often result in the exacerbation of
symptoms associated with IBS.
• Causative agents and risk factors include weak or malfunctioning
immunity, positive family history, chronic stress and poor dietary
nutrients, diseases like Diabetes Mellitus which increases the
susceptibility of bowel inflammation and the use of Isotretinoin, a
drug which is used to treat acne. In addition, this condition usually
affects women and men who are younger than 30 years of age. But it
can arise at any age
• Main Difference – IBD vs IBS
• Inflammatory bowel disease (IBD) and Irritable bowel syndrome (IBS)
are two medical conditions related to the gastrointestinal system,
particularly affecting the intestinal part of it.
• Not eating enough high-fiber foods. High-fiber foods keep food
moving through the digestive system.
• Taking certain medications (see causes).
• Having certain neurological (diseases of the brain and spinal cord)
and digestive disorders (see causes).
Diverticula are small, bulging pouches that can form in the lining of your
digestive system. They are found most often in the lower part of the
large intestine (colon). Diverticula are common, especially after age 40,
and seldom cause problems.
This procedure is done using a long, flexible
tube called an endoscope. The tube has a tiny
light and video camera on one end. The tube is
put into your mouth and throat. Then it is
slowly pushed through your esophagus and
stomach, and into your duodenum.
• Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in
your anus and lower rectum, similar to varicose veins. Hemorrhoids
can develop inside the rectum (internal hemorrhoids) or under the
skin around the anus (external hemorrhoids)
• Piles are mainly the swollen blood vessels while fissures are kind of
cracks and fistulas are an opening of a cavity. Piles are mostly
painless and unnoticeable. Fissures cause a lot of pain. In the case of
fistulas, pus is discharged out of the anal area.
• What is constipation? Constipation is a condition in which a person
has fewer than three bowel movements a week or has bowel
movements with stools that are hard, dry, and small, making them
painful or difficult to pass.s food normally moves through the
digestive tract, nutrients are absorbed. The partially digested food
(waste) that remains moves from the small intestine to the large
intestine, also called the colon.
• The colon absorbs water from this waste, which creates a solid
matter called stool. If you have constipation, food may move too
slowly through the digestive tract. This gives the colon more time –
too much time – to absorb water from the waste. The stool becomes
dry, hard, and difficult to push out.
• Can constipation cause internal damage or lead to other health
problems?
• Swollen, inflamed veins in your rectum (a condition called hemorrhoids).
• Tears in the lining of your anus from hardened stool trying to pass through
(called anal fissures).
• An infection in pouches that sometimes form off the colon wall from stool
that has become trapped and infected (a condition called diverticulitis)
• A pile-up of too much stool/poop in the rectum and anus (a condition
called fecal impaction).
• Damage to your pelvic floor muscles from straining to move your bowels.
These muscles help control your bladder. Too much straining for too long a
period of time may cause urine to leak from the bladder (a condition
called stress urinary incontinence).
• hat’s the difference between normal diarrhea and severe diarrhea?
• There are actually several different ways to classify diarrhea. These types of
diarrhea include:
• Acute diarrhea: The most common, acute diarrhea is loose watery diarrhea
that lasts one to two days. This type doesn’t need treatment and it usually
goes away after a few days.
• Persistent diarrhea: This type of diarrhea generally persists for several
weeks – two to four weeks
• Chronic diarrhea: Diarrhea that lasts for more than four weeks or comes
and goes regularly over a long period of time is called chronic diarrhea.
• What causes diarrhea?
• The cause of most self-limited diarrhea is generally not identified. The most common
cause of diarrhea is a virus that infects your bowel (“viral gastroenteritis”). The infection
usually lasts a couple of days and is sometimes called “intestinal flu.”
• Other possible causes of diarrhea can include:
• Infection by bacteria.
• Infections by other organisms and pre-formed toxins
• Eating foods that upset the digestive system.
• Allergies and intolerances to certain foods (Celiac disease or lactose intolerance).
• Medications.
• Radiation therapy.
• Malabsorption of food (poor absorption).
• BRAT diet:B: Bananas.
• R: Rice (white rice).
• A: Applesauce.
• T: Toast (white bread).