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Long-term use of PPIs is associated with the development of benign polyps from fundic glands (which is distinct from fundic gland polyposis); these polyps do not cause cancer and resolve when PPIs are discontinued. [33] There is concern that use of PPIs may mask gastric cancers or other serious gastric problems. [33]
Complications of an ulcer can cause severe signs and symptoms such as black or tarry stool indicative of bleeding into the stomach or duodenum; blood - either red or coffee-ground colored in vomit; persistent sharp or severe abdominal pain; dizziness, and a fast heartbeat. [67] [68] Bleeding is the most common complication.
Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases. [5] [6] [13] If other measures are not effective, an esophageal balloon may be attempted in those with presumed esophageal varices. [2]
Proton pump inhibitors are prodrugs and their actual inhibitory form is somewhat controversial. In acidic solution, the sulfenic acid is isolated before reaction with one or more cysteines accessible from the luminar surface of the enzyme, a tetracyclic sulfenamide. This is a planar molecule thus any enantiomer of a PPI loses stereospecifity ...
Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine the hemoglobin.
Fundic gland polyposis is a medical syndrome where the fundus and the body of the stomach develop many fundic gland polyps.The condition has been described both in patients with familial adenomatous polyposis (FAP) and attenuated variants (AFAP), and in patients in whom it occurs sporadically.
The H 2 receptor antagonists are a class of drugs used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells. H 2 antagonists are used in the treatment of dyspepsia, although they have been surpassed in popularity by the more effective [1] proton pump inhibitors.
It can be caused by persistent infection with Helicobacter pylori, or can be autoimmune in origin. Those with autoimmune atrophic gastritis ( Type A gastritis ) are statistically more likely to develop gastric carcinoma (a form of stomach cancer ), Hashimoto's thyroiditis , and achlorhydria .