Flashcards in Peptic Ulcer Disease Deck (27):
What are peptic ulcers?
Ulceration within the stomach or duodenum
Which type of peptic ulcer is more common?
DU = 4x more common than GU
In which population do gastric ulcers mainly occur?
Causes of peptic ulcers:
* H. pylori infection
* Smoking (GU mainly)
H. pylori is associated with what percentage of peptic ulcers?
What percentage of those >50 are infected with H. pylori?
Infection with H. pylori results in what?
Leading in some to peptic ulceration
Leading in some to gastric cancer
Which blood group is associated with each type of peptic ulcer?
General risk factors for peptic ulcer disease:
* Alcohol abuse
* Advancing age
* Low SES
Risk factors for GU:
* H. pylori (80% cases)
* Reflux of duodenal contents
* Delayed gastric emptying
* Severe physiological stress (Cushings/Curlings)
What are Curling's and Cushing's ulcers?
Gastric ulcers induced by severe physiological stress
Curling's: Severe burns
Cushing's: Raised ICP
Risk factors for DU:
* H. pylori (90% cases)
* Increased gastric acid secretion
* Rapid gastric emptying
* Blood group O
Symptoms of peptic ulcer disease:
* Epigastric pain
Worsened by eating in GU
Improved by eating in DU
* Fullness after meals
* Oral flatulence
* Pain radiating to back
Red flag features of peptic ulcers:
Loss of weight
Signs in peptic ulcer disease
* Non-ulcer dyspepsia
* Gastric malignancy
* Crohn's disease
* Zollinger-Ellison syndrome
* Chronic pancreatitis
* Pancreatic Ca
Methods of H. pylori testing:
1. Carbon-13 urea breath test
2. Stool antigen test
When is endoscopy required in peptic ulcer disease:
If any ALARM Sx
Investigations for peptic ulcer disease:
1. FBC ?IDA
2. H. pylori testing
Lifestyle management of peptic ulcer:
* Smoking cessation
* Reduce alcohol
* Review medications
H. pylori eradication therapy:
PPI + 2x ABX
e.g. Lansoprazole 30mg BD, Clarithromycin 250mg BD + Amoxicillin 1g BD
Management plan for peptic ulcers:
2. Test for H. pyloti
How long should PPIs be continued for in peptic ulcer disease?
4 weeks DU
8 weeks GU
Indications for surgical management of peptic ulceration:
Complications of peptic ulceration:
Gastric outflow obstruction
Patient's on which medication may present later and with fewer defining symptoms of peptic ulcer perforation?