Gastric Ulcer vs Duodenal Ulcer?

[Kluver_Bucy]

Question #22 in GI section of 2nd edition in Robbins Q book. The answer specifies that gastric ulcers are worse 2-3 hours after a meal, and can be aleviated by eating more food. Isn't this the clinical picture for duodenal ulcers. I thought gastric ulcers are worse with eating thus these patients tend to be skinny, while duodenal ulcers patients tend to be obese because eating food aleviates the ulcer. I am confused! Thanks for your help.

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[Ramoray]

wouldnt it alleviate both types since the food sops up the acid, i mean not technically but technically speaking the more food you have it lowers the amt of acid or something doesnt it so more food would mean less acid, mean alleviation of both

 

[Kluver_Bucy]

wouldnt it alleviate both types since the food sops up the acid, i mean not technically but technically speaking the more food you have it lowers the amt of acid or something doesnt it so more food would mean less acid, mean alleviation of both

That is what I thought but I heard the clincal picture of eating a food can separate the two? Maybe I should post this question on the GI forum. I already posted a question about air on GI scans vs no air on GI scans as a diagnostic tool to distinguish ulcerative colitis, GI cancer, obstipation, constipation. These Robbins Q are tough. Thanks Ramoray for replying.

 

[cytoskelement]

eating should separate the two types of ulcers.

eating should increase gastric ulcer pain and decrease duodenal ulcer pain.

my guess would be the response to food. gastrin would increase and stimulate acid production --> increasing gastric pain. secretin, in response to acid secretion and fatty acids, would increase bicarb in the duodenum thus neutralizing acid and relieving duodenal pain.

 

[Ramoray]

eating should separate the two types of ulcers.

eating should increase gastric ulcer pain and decrease duodenal ulcer pain.

my guess would be the response to food. gastrin would increase and stimulate acid production --> increasing gastric pain. secretin, in response to acid secretion and fatty acids, would increase bicarb in the duodenum thus neutralizing acid and relieving duodenal pain.

ya that is indeed right regarding the seperation of the 2 as i just looked it up but the reasons harrison gave said that the mechanism of pain induced is not known and only listed some speculations so i think its someting good just to memorize to seperate the 2. good post!

 

[Kluver_Bucy]

Thanks guys. Here is a link to my other GI questions on a different thread.

http://forums.studentdoctor.net/showthread.php?t=206660

 

[Pox in a box]

Trust me...diagnosis based on what you feel like when you eat is BAD MEDICINE. You'll have to have more information. I had a duodenal ulcer (confirmed by biopsy as H. pylori with an esophagogastroduodenoscopy sample) and eating made it worse. Generally, the rule is that duodenal makes you feel better when you eat (so you'd gain weight) and the opposite for the gastric ulcer. The important key here is that 100% are H. pylori in duodenal and only about 70% for gastric. Remember this...H. pylori can cause cancer (MALToma, gastric lymphoma) but it's the only cancer that can be eliminated once you remove the bug.

 

[irrka]

who is MALToma?

 

[Idiopathic]

A lymphoma of the Mucosa Associated Lymphoid Tissue in the gut.

 

[Pox in a box]

A lymphoma of the Mucosa Associated Lymphoid Tissue in the gut.

Yup.