primary care physician with a 2 month history of intermittent burning epigastric pain. He describes the pain as dull, gnawing ache. The pain sometimes wakes him at night, is relieved by food and is helped partially by antacids such as Maalox. He had a similar but milder episode about 5 years
A 40 year old man presents to his primary care physician with a 2 month history of intermittent burning epigastric pain. He describes the pain as dull, gnawing ache. The pain sometimes wakes him at night, is relieved by food and is helped partially by antacids such as Maalox. He had a similar but milder episode about 5 years ago which was treated by omeprazole.
Physical examination reveals a fit, apparently healthy man in no distress, but with mild epigastric tenderness on palpation of the abdomen.
History revealed that he has been smoking for the past 20 years. 1 pack per day. He has also been taking Ibuprofen for the past 3 weeks because of an injury to his knee while playing basketball. He is a self confessed workaholic who operates 3 foodchains.
Based on the clinical history and physical examination, the patient was diagnosed to have peptic ulcer disease.
1. Peptic ulcers can occur in the stomach or duodenum. What tunic layer is affected by PUD? Describe briefly the tunic layers of the stomach and duodenum.
2. Explain the pathophysiology of PUD. What are the gastric and duodenal secretions which protect the mucosa from damage by acidic environment and chemical irritants?
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