Peptic Ulcer Disease Flashcards
what is peptic ulcer disease
Ulceration of areas of the GI tract caused by exposure to gastric acid and pepsin. Peptic ulcers are most commonly gastric and duodenal (but they can also occur in the oesophagus and Meckel’s diverticulum)
what usually protects the stomach lining from acid
mucin, bicarbonate secretion and mucosal blood flow
what bacterium can cause peptic ulcer disease
H. pylori
causes of peptic ulcers
90% of the time it is due to H.pylori
othercauses:
NSAIDs, chronic steroid use, SSRIs, increased gastric acid secretion
risk factors for peptic ulcer disease
H.pylori infection, NSAIDs, severe stress, smoking,
presenting symptoms of peptic ulcer disease
epigastric pain, relieved by antacids, haematemesis and melaena
pain worse after eating
difference between pain after eating in duodenal and gastric ulcers
duodenal- pain worse after several hours of eating
gastric- pain worse straight after eating
what may be some signs of peptic ulcer disease
epigastric pain and tenderness and signs of complications such as anaemia
what investigations will be done for peptic ulcer disease
bloods- FBC, amylase, U&Es, LFTs
endoscopy; biopsy to rule out malignancy (only gastric ulcers are biopsied)
rockall scoring
test for H.pylori
why is amylase measured
to exclude pancreatitis
what is the rockall scoring for
to estimate prognosis after a GI bleed
how to manage peptic ulcer disease
4-6 week PPI treatment and lifestyle advice
what lifestyle advice will be given to those with peptic ulcer disease
stop smoking
reduce alcohol
regular, smaller meals
avoid acidic, spicy, fatty foods
weight loss
avoid stress
avoid NSAIDs, SSRIs
prognosis of patients with peptic ulcer disease
Patients with a gastric ulcer should have a repeat endoscopy 6-8 weeks after the start of PPI treatment to ensure ulcer healing and rule out malignancy
