Peptic Ulcer Disease

Question 1

Aetiologies?

Answer 1

H. PYLORI INFECTION
NSAIDs 
Zollinger-Ellison syndrome
Hyperparathyroidism
Crohn's 
Increased gastric emptying (DU)
Smoking (GU)

Question 2

Pathology?

Answer 2

Chronic inflammation of areas colonised by H. pylori –> acid erosion
Acid erosion of normal mucosa by other causes

Question 3

Signs and Symptoms?

Answer 3

Epigastric pain +/- tenderness
Nocturnal hunger/pain (DU)
Back pain (DU)
N+V 
Weight loss
Haematemesis 
Melaena

Question 4

Investigations and Findings?

Answer 4

Test for H. pylori - positive if infection

Upper GI endoscopy - visualise ulceration

Question 5

Management?

Answer 5

Avoid causative foods and smoking
Treat H. pylori - triple therapy (clarithromycin, amoxicillin and PPI)
Stop NSAIDs
Surgical management is last resort

Question 6

Complications?

Answer 6

Scarring
Acute bleed
Perforation