Heartburn and Ulcers

Course overview

This course will help participants understand the causes of peptic ulcers and gastro-esophageal reflux disease (GERD). Participants will learn to recognize symptoms of peptic ulcers and GERD as well as understand the treatment for such illnesses. Participants will learn about the link between peptic ulcers, GERD and certain cancers and prevention of both diseases. Peptic ulcers are erosions in the stomach or small intestine. They are most often caused by the use of non-steroidal anti-inflammatory drugs (NSAIDS) and infection with a bacteria called Helicobacter pylori (H. Pylori). H. pylori are also associated with gastritis, gastric cancer, and mucosa-associated lymphoid-tissue lymphomas. More than 300,000 patients are admitted to hospitals in America due to bleeding peptic ulcers and 7%-10% of these patients die from hemorrhage. Peptic ulcers cause serious complications, and it is important for participants to be familiar with the warning signs associated with peptic ulcers. This course begins with a history of the scientific research on the possible causes of ulcers, dating back to 1783 when Lazzaro Spallanzani first hypothesized that the stomach uses a strong acid to digest food. By the end of the 19th century, the immediate cause of peptic ulcers was determined to be stomach acid, but since then research has pointed to several catalysts. For example, stress and nicotine diminish blood-flow to the gastric mucosa, reducing the protective layer of the stomach and creating conditions in which an ulcer can develop. Varying populations suffer from peptic ulcers. Hospitalized patients and ambulatory patients are high risk for developing peptic ulcers. Many elderly patients are taking NSAIDS for arthritis and other patients have lifestyle habits that put them at risk. Participants will recognize the signs of developing ulcers and gastritis. Such information will enable them to convey information on how to properly prevent ulcers. This course explains the causes of peptic ulcers, which include the use of NSAIDS, H. Pylori, smoking, excessive alcohol use, and stress. It also reviews the Zollinger-Ellison syndrome, which is a gastrin-secreting tumor. The course further explains the diagnosis and treatment for peptic ulcers caused by H. Pylori. This course goes on to discuss gastroesophageal reflux disease (GERD), its causes, symptoms and treatment. GERD can lead to Barrett's Esophagus, which can lead to esophageal cancer. Of particular importance are two public health surveys called HUNT (Helseundersokelse I Nord-Trondelag 1) and HUNT 2. The surveys found that tobacco use and high salt intake significantly increased the incidence of GERD but alcohol did not. Of further interest, the surveys showed that people who reportedly drank a lot of coffee, ate high fiber bread and exercised regularly cut their risk in half. This study was limited by the lack of endoscopic confirmation of GERD. Upon completion of this course, participants will be aware of the cutting-edge knowledge about ulcers, heartburn and GERD, as well as diagnostic evaluations and treatment methods. Participants will be prepared to offer appropriate advice about treatment methods and exercises, and to discuss the effectiveness of various treatment methods with patients. This will enhance the patient's progress and receptiveness to therapy.