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Tuesday, 26 November 2013

GastrIc Ulcers: The Diagnosis

The prevalence of upper gastrointestinal (GI) diseases is increasing in subjects aged 65 years and over. Pathophysiological changes in esophageal functions that occur with aging may, at least in part, be responsible for the high prevalence of
1. Gastro-esophageal reflux disease (GERD) in old age.
2. The incidence of gastric and duodenal ulcers and their bleeding complications is increasing in old-aged populations worldwide.
3.  H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis
4.  Almost 40% of GU and 25% of DU in the elderly patients are associated with the use of NSAID(1) and/or aspirin(2).(a)
II. Gastric ulcers
Gastric ulcer, a type of peptic ulcer is defined as a condition of a localized tissue erosion in the lining the stomach.
F. Diagnosis
If you are experience the symptoms of gastric ulcer as mentioned above, a complete physical examination (rectal exam) and  and medical (weight loss or fatigue, present and past medication use including chronic use of NSAID)  and family history( If your family has a history of gastric ulcer) should be recorded to rule out other diseases with the same symptoms (Gallstones, heart condiction, GERB, etc.)
F1. Non invasive testing
1. Blood test (Complete blood count)
The aim of the test is to check for the abnormally high or low counts which may be an indication of infection.
2. Fecal occult blood test (FOBT)
This is a test tocheck for hidden (occult) blood in the stool (feces) with an aim to detect subtle blood loss in the gastrointestinal tract.
3. Screen for Helicobacter pylori test
If your doctor suspects that you have gastric ulcer due to infection, screen for Helicobacter pylori  test may be ordered, including Blood antibody test, Stool antigen test, Urea breath test, etc.)
4. Endoscopy 
Endoscopy is a procedure for your doctor look inside your body with an endoscope, (a long, thin tube equipped with a tiny video camera) to detect any abnormality including  the presence of peptic ulcers, bleeding, stomach cancer, etc.
5. Biopsy 
In biopsy, a sampling of tissues is withdrawn for examination.
6. Etc.
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/15588798
(1) http://www.ncbi.nlm.nih.gov/pubmed/16001646
(2) http://www.ncbi.nlm.nih.gov/pubmed/22542157