Gastric Ulcer

Question 1

Epidemiology

Answer 1

most common among middle-aged adults.
10% lifetime incidence
M>W slightly

Question 2

Aetiology

Answer 2

Nearly all ulcers are caused by Helicobacter pylori infection or NSAID use
Cigarette smoking
stress

Question 3

Pathogensis

Answer 3

A peptic ulcer is an erosion in a segment of the GI mucosa due to weakened mucosal defences

duodenal mucosa exists in the form of a gel layer, which is impermeable to acid and pepsin. Other gastric and duodenal cells secrete bicarbonate, which aids in buffering acid that lies near the mucosa. Prostaglandins of the E type (PGE) have an important protective role, because PGE increases the production of both bicarbonate and the mucous layer

Question 4

Natural History

Answer 4

gastric cancer if untreated

Question 5

Clinical Manifestations

Answer 5

Hpylori test.

Question 6

Symptoms

Answer 6

burning epigastric pain that is often relieved by food - antiacids

often asymptomatic

Question 7

Signs

Answer 7

use of NSAIDS/Aspirin

stool colour - bleeding

Question 8

Complications

Answer 8

occult bleeding, perforation, haemorrhage, obstruction due to scarring,
3-6x increased risk of gastric cancer

Question 9

Prognosis

Answer 9

The 3-yr recurrence rate for gastric and duodenal ulcers is 50% when it is not.
Life style changes/Stress management
cessation of NSAID treatments