Peptic Ulcer Flashcards
Which type of peptic ulcer is most common?
Duodenal ulcer
What physiological processes contribute to peptic ulcer formation?
- Breakdown in protective layer (mucus + bicarbonate)
or
- Increase in stomach acid production
Who’s more likely to get peptic ulcers, male or female?
Female
What are the causes of peptic ulcer?
Protective layer breakdown:
- drugs (NSAIDs, long-term steroids, SSRIs)
- H. pylori MOST COMMON CAUSE
Increased acid production:
- stress/alcohol/spicy food/smoking/caffeine
What condition poses an increased risk to developing GORD?
Crohn’s disease
Describe the symptom pattern of gastric and duodenal ulcers when eating
Gastric - pain worsens after eating
Duodenal - pain improves after eating
(pain in the hours after eating points to duodenal)
Name some signs and symptoms of peptic ulcer
Nausea and vomiting
Coffee ground vomiting
Melaena
Iron deficiency anaemia
Early satiety
How do you diagnose peptic ulcer?
Diagnosis is by endoscopy, but PPIs should be stopped 2 weeks prior
(during this a rapid urease test can be performed to check for H.pylori, and biopsy can be done to exclude malignancy)
What are the non-invasive methods of investigating H.pylori infection?
Stool antigen test
Urea breath test
What is the management of an actively bleeding peptic ulcer?
1st line - endoscopy/blood transfusion/PPI
2nd line - surgery
What is the management of a peptic ulcer that isn’t bleeding, without H.pylori infection?
1st line - treat underlying cause and give PPI
2nd line - add in ranitidine
What is the management of a peptic ulcer that isn’t bleeding, with H. pylori infection?
Eradicate with triple therapy for 7 days
What are the complications of a peptic ulcer?
Haemorrage
Perforation (leading to infection)
Pyloric stenosis due to scarring of muscle and mucosa
