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Duodenal ulcer,Gastric

Duodenal ulcer,Gastric
  • FISSURE IN ANO
  • Fissure is the crack in skin lined the anal canal.often shows reluctance to heal.fissures usually extend from anal canal lies posterior to the midline.
  • Most of the anal fissures are caused stretching the anal mucosa beyond its capability.
  • Incidence of anal fissure is 1 in350 adults.it is common in both male and females Common in 15 yr to 40 yr old people.
  • CAUSES:
  • 1 constipation is the main cause which strains anal mucosa.
  • 2 spasm of the internal anal sphincter
  • 3 when too much of skin removed during operation for piles.
  • SECONDARY CAUSES:
  • 1 ulcerative colitis
  • 2 crohns disease
  • 3 syphilis
  • 4 tuberculosis
  • 5 child birth
  • 6 low fiber diet
  • There are two types of fissure,acute fissure in ano,and chronic fissure in ano
  • ACUTE FISSURE IN ANO:it is a tear of the skin lower half of the anal canal,there is hardly any inflamtory induration or oedema
  • CHRONIC FISSURE IN ANO:deep canoe shaped ulcer with oedematous margins.lower end of the ulcer there is skin tag called sentinel pile,characteristic inflammation and induration
  • CLINICAL FEATURES:
  • 1 pain starting with following with defaecation.
  • 2 sharp biting burning pain.pain continuous after passing stool.
  • 3 bleeding seen while passing stool,streaks of blood seen.
  • 4 pruritis ani.
  • PREVENTION OF FISSURE IN ANO:
  • 1 avoid excessive strain during passing stool
  • 2 avoid constipation
  • 3 taking proper diet rich in fiber
  • 4 taking plenty of water
  • 5 maintaining proper hygiene after passing stool , ie sitz bath
  • HOMEOPATHIC REMEDIES FOR FISSURE IN ANO:
  • 1 FISSURE BLEEDING AFTER STOOL:NIT ACID,CALC CARB,NAT MUR,GRAPHITIS,RATANHIA
  • 2 FISSURE OOZING :GRAPHITIS , SYPHILINUM,TUBERCULINUM
  • 3 FISSURE MUCH PAINFULL:GRAPHITIS,RATANHIA,SYPHILINUM, LAC DEFLORATUM,THUJA
  • 4 FISSURE PAINLESS:ALOE SOCOTRINA,PHOS
  • 5 FISSURE PREGNANCY DURING: IGNATIA,NIT ACID,NUX VOMICA,SEPIA,SULPHUR,THUJA
  • What are Duodenal or Peptic Ulcers?
  • PEPTIC ULCER
  • Peptic ulcer is sore in the lining of stomach ,first part of small intestine known as duodenum.burning pain is the common symptom.starts
  • before or after meals,troubles more during nights.
  • Pain lasts for minutes to hours.suffers from days to weeks.
  • Peptic ulcer happens when the acids that helps to digest the food , damages the lining of stomach ,duodenum
  • Peptic ulcers may be acute ulcers which are shallow and multiple.chronic ulcers are single deep ,scirrhous.
  • CAUSES FOR ACUTE ULCER:
  • 1 half of the patients suffers from acute ulcers because of ingestion of aspirin,and pain killer drugs.
  • 2 Stress causes more secretion of acid and forms stress ulcer.
  • 3 After cerebral trauma and neurological operations forms cushing ulcers.this is because of higher gastrin levels.
  • 4 After suffering from major burns , ulcers forms known as curlings ulcer.
  • 5 Patients on steroids may develop acute ulcers known as steroid ulcers
  • 6 Helicobacter pylori infection.
  • CAUSES FOR CHRONIC PEPTIC ULCERS:
  • 1 diminished mucosal resistance.
  • 2 pyloro duodenal reflux,regurgitated bile and duodenal juices causes for the formation ulcers in stomach
  • 3 deficient mucosal barrier:a surface layer of mucus protects from acid.when this layer is deficient ,causes ulcers
  • 4 anxiety stress,sleeplessness
  • 5 irregular diet ,spicy food,excessive drinking of tea
  • 6 smoking drinking
  • PATHOLOGY:
  • Gastric ulcers may be acute or chronic.85 per chronic ulcers are found in lesser curvature.10 percent found in antrum,2 percent in pyloric canal, 5 per in fundus.
  • Acid which helps in digestion of food destroys the mucosa of the stomach forms ulcers.
  • These ulcers sometimes shows proliferative changes turns into carcinoma of stomach
  • CAUSES FOR DUODENAL ULCERS:
  • 1 hypersecretion of hydrochloric acid by stomch.usually it 2 times morethan the normal levels
  • 2 genetic factors.people who have strong family history of ulcers,persons of blood group o are apt to develop duodenal ulcers.
  • 3 endocrine organ dysfunction:over production of gastrin by pancreatic tumour condition known as ZOLLINGER ELLISON SYNDROME.cushing syndrome causes ulcers because of excessive steroid secretion.parathyroid tumour causes ulcer because of hyper calcaemia
  • 4 chronic liver disease
  • 5 emotional factors such as anxiety depression,stress
  • 6 irregular diet ,spicy food,excessive drinking of tea,
  • 7 smoking ,drinking alcohol
  • CLINICAL FEATURES OF ULCER AND DIFFERENCE BETWEEN GASTRIC ULCER AND DUODENAL ULCER
Chronic gastric ulcer duodenal ulcer
1 patients are usually middle age 1 usually young adults
2 more common in males 2 common In both sexes
3 patients look thin 3 patients look obese
4 periodicity is less marked 4 periodicity is well marked
5 pain in mid epigastrium slightly 5 pain in transpyloric plane To left
6 taking food aggravates the pain 6 taking food relieves the pain
7 pain is not felt at night 7 pain felt at night
8 vomiting is common found after food 8 vomiting is rare unless pyloricstenosis complicates
9 pt learn to avoid spicy food 9 any food doesn’t intiate pain so He doesn’t avoid
10 pt looses weight 10 pt gains weight
11 haematemesis is common 11 memaena is more common
  • DIAGNOSIS FOR PEPTIC ULCER:
  • 1 upper gi endoscopy
  • 2 cbp
  • 3 stool examination for occult stool.
  • 4 gastric function test
  • 5 barium meal x ray test
  • COMPLICATIONS OF PEPTIC ULCER
  • 1 haemorrhage.haematesis or malena
  • 2 perforation of ulcer leads to peritonitis
  • 3 duodenal ulcer can complicate as pyloric stenosis
  • 4 ulcer may turn into carcinoma
  • HOMEOPATHIC TREATMENT FOR PEPTIC ULCER
  • 1 burning pain after eating : carbo veg,kali carb,phos,kali bich , nat mur,these are the drugs helps in treating gastric ulcers
  • 2 eating amoeliarates pain:aesc,graphitis,nat mur
  • 3 burning pain in drunkards: sulphuric acid
  • 4 burning pain after dinner lyc.
  • Other remedies are nux vomica, anacardium,sulphur,natrum sulph,robinea,natrumphos
  • NUX VOMICA: heaviness after eating food. Nausea vomiting after food.stomach is very sensitive to pressure.bloating in epigastrium.desiresspicy , fat food.desires for stimulants
  • NATRUM PHOS: sour eructation,sour vomiting,greenish diarrhoea.excessive flatulence,dyspepsia.sour vomiting
  • PHOSPHORUS: hunger soon after eating.sour erructations after meal,loud belchings after food.throughs ingesta by mouthfuls.vomits water as soon as it gets warm in stomach.cardiac opening seems to be contracted Stomach pain is relieved by taking cold water.
  • ANACARDIUM:
  • empty feeling sensation in stomach,weak digestion with fullness distension.erructations ,nausea vomiting.eating relieves the pain