Peptic Ulcer Disease
Evaluation
General—lesion of the mucous membrane lining the stomach or duodenum
Clinical—epigastric pain (aching, gnawing) that can be intermittent, dyspepsia, with or without nausea/vomiting
Gastric ulcer—pain occurs minutes after eating and can last for hours (until stomach is empty).
Duodenal ulcer—pain relieved by eating, but may return up to 4 hours later.
Etiology—many factors are associated with peptic ulcer disease (PUD), although these are the most common
Helicobacter pylori infection—acts by inducing mucosal inflammation and cytokine release.
Nonsteroidal anti-inflammatory drug (NSAID)/aspirin use— acts by inhibiting prostaglandin synthesis, which protects mucosa.
Those who use these agents are also at increased risk of complicated ulcers, bleeding, and so on.
Epidemiology—8% to 14% lifetime prevalence with complicating ulcer disease occurring with increased age
Advanced age (age older than70 years)
History of PUD or complicated ulcer disease
Concomitant warfarin or corticosteroid administration
Smokers—These individuals having impaired ulcer healing
Alcohol—unclear effect on patients without coexisting liver disease
Diagnostic algorithm—typically encompasses the differential of dyspepsia (see Chapter 2.24)
Treatment
H. pylori-related PUDRelated posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
