Peptic ulcer disease

Question 1

Indication for EGD

Answer 1

1. Occult bleeding
2. Alarm symtpoms
   - wt loss
   - anemia
   - melena/frank GI blood loss
   - early satiety
   - dysphagia

Question 2

medication managment for hx of peptic ulcer

NSAIDs
ASA

Answer 2

NSAIDs

• permanently d/c NSAIDs
• if going to restart, use selective COX-2 inhibitor (celocoxib) + PPI to reduce bleeding risk

Aspirin for ASCVD

• ok to continue
• if recent bleed and need for secondary prevention, restart 7 days after resolution of UGIB

Question 3

describe gastric acid suppression regimen for peptic ulcer disease

Answer 3

Duodenal ulcer: 8 weeks

Gastric ulcer: 12 weeks

Question 4

follow up EGD timeline

Answer 4

6-12 weeks after initial Tx for gastric ulcer to r/o malignancy

repeat EGD not routinely indicated for duodenal ulcers