GASTRITIS Primary HP 10 western Countries up to

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GASTRITIS Primary HP 10% western Countries up to 100% in under developed countries. Primary

GASTRITIS Primary HP 10% western Countries up to 100% in under developed countries. Primary duodenal ulcer almost always HP Very rare in children below 1 year.

GASTRITIS SECONDARY CAUSES: 1. 2. 3. 4. 5. Severe Stress Systemic illness, Burns Head

GASTRITIS SECONDARY CAUSES: 1. 2. 3. 4. 5. Severe Stress Systemic illness, Burns Head injury NSAID Ibuprofen mefanamic acid * inhibit HCo 3 Secretion *5 folds High risk of massive bleeding Cauresive gastritis mainly Oesphagus Croh’s disease 30% ulcer, Can occur at any age, Associated with high mortality Others Iron Kcl Antibiotics Penicillin Tetracyclin Cephalosporin

PATHOGENESIS Peptic ulcer disease described as a discontinuity in gastric and duodenal mucosa exposed

PATHOGENESIS Peptic ulcer disease described as a discontinuity in gastric and duodenal mucosa exposed to acid or pepsin. Cause: Loss of balance between mucosal protective mechanism and aggressive factors of acid and pepsin production. Peptic ulcer: deep mucosal lesion Penetrate muscle layer Peptic erosion Superficial mucosal lesion Don’t penetrate muscle coat Site Gastric Lesser curvature 90% duodenal palb

Definition of Gastritis Microscopic evidence of inflammation affecting the gastric mucosa TYPES: Active PMNL

Definition of Gastritis Microscopic evidence of inflammation affecting the gastric mucosa TYPES: Active PMNL Chronic Nop. MNL Plasma cells Chronic Active both acute and chronic inflammatory cells Atrophic Autoimmune Anti parietal cell Ab

HP colonization of gastric mucosa Adults Children acute gastritis metaplasia chronic gastritis in nature

HP colonization of gastric mucosa Adults Children acute gastritis metaplasia chronic gastritis in nature no metaplasia Etiology Acid Pepsin aggressive factor host defense * * HCo 3 + water mucous layer Blood flow rapid cell turnover

PEPTIC ULCER IN CHILDREN a. d. Incomplete pentrance of hyper pepsingemia in children and

PEPTIC ULCER IN CHILDREN a. d. Incomplete pentrance of hyper pepsingemia in children and parents Blood group O 3 times more common in twins. 60% of children have 1 st degree relatives with peptic ulcer disease.

SYMPTOMS Epigastric pain Fullness nausea vomiting Anorexia Abdominal pain in children present as irritability

SYMPTOMS Epigastric pain Fullness nausea vomiting Anorexia Abdominal pain in children present as irritability change of normal feeding pattern IDA resistant treatment fatigue

: Zellinger – Ellison disease More in male Triad Severe ulcer disease gastric acid

: Zellinger – Ellison disease More in male Triad Severe ulcer disease gastric acid hyper secretion gastrinoma Pancreas Gastric duodenal

How to diagnose Barium contrast study… not sensitive about 40% missed Upper GI Endoscopy

How to diagnose Barium contrast study… not sensitive about 40% missed Upper GI Endoscopy The investigation of choice 3 biopsies Gross nodularty indicate HP infection in children not adult The value is doubtful in acute bleeding

PROTECTION adequate nutritional states erp frequent consumption of fruits and vegetable Vit. C? HP

PROTECTION adequate nutritional states erp frequent consumption of fruits and vegetable Vit. C? HP gm –ve spiral shaped , unibolar flagellated bacteria Colonize gastric mucosa anywhere. There is an association between chronic HP Colonization and development of gastric cancer. Mode of transmission Dental plaques fears person to persons “vomiting”