Acid-peptic diseases of the stomach and duodenum including Helicobacter pylori and NSAIDs

Published on May 5, 2014 Updated on August 7, 2014   48 min

Other Talks in the Series: Gastroenterology and Hepatology

0:00
My name is Sheila Crowe. I'm a professor of medicine at the University of California in San Diego. I'm going to be discussing acid peptic diseases of the stomach and duodenum, including H. pylori infection and NSAIDs.
0:19
To start, I would like to talk about the clinical presentations of H. pylori infection. The most common presentation is an asymptomatic infection in which the patient has no idea they're infected. Another presentation is indigestion, or what we call this dyspepsia. Additionally, H. pylori can lead to gastric ulcer and also duodenal ulcer. Perhaps one of the more serious long term presentations of H. pylori infection is the development of gastric adenocarcinoma, and a relatively rare presentation is a special kind of lymphoma known as the MALT lymphoma, because it involves the Mucosal Associated Lymphoid Tissue.
1:07
In modern times, we've recognized that this infection, which we think dates back many years, has actually changed in its incidence in association with different upper gastrointestinal diseases. If you look at the graph, you will see the relative incidence of the event, the different types of presentations of upper GI problems, and you'll see over the decades going from 1900 to more modern times that there has been a decline in the H. pylori infection, and with that you see a decrease in duodenal ulcer, gastric ulcer, and in Western countries, gastric cancer. At the same time, there have been some other changes, which we won't get into much detail here, is the rise of reflux esophagitis, Barrett's esophagus, and adenocarcinoma of the esophagus. Now this diagram does not apply to Eastern countries and some more of the developing countries in the world where H. pylori remains quite prevalent.
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Acid-peptic diseases of the stomach and duodenum including Helicobacter pylori and NSAIDs

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