Peptic Ulcer

Question 1

Peptic ulcer?

Answer 1

• Is a lesion or ulceration in the lining (mucosa) of the digestive tract, typically in the gastric or duodenum (most common)

Question 2

Clinical presentation?

Answer 2

• Epigastric discomfort or pain
• Vomiting & nausea
• Dyspepsia (indigestion سوء الهضم)

Question 3

Signs of upper gastrointestinal bleeding ?

Answer 3

• Hematemesis (vomiting blood)
• Melaena (black, tarry stools)
• Fall of Hemoglobin in full blood count

Question 4

The rhythm of pain in Gastric ulcer (GU)?

Answer 4

• Eating typically worsens the pain of gastric ulcers (15-30min after a meal)

Question 5

The rhythm of pain in Duodenal ulcer (DU) ?

Answer 5

• The pain of duodenal ulcers tends to improve immediately after eating, followed by pain 2-3 hours later.

Question 6

Causes ?

Answer 6

• Stress
• Caffeine
• Smoking
• Alcohol
• Spicy food
• NSAIDs
• H.pylori

Question 7

Diagnosis?

Answer 7

• Endoscopy
• CLO teat during endoscopy for H. pylori ( bacteria found in the stomach)
• A biopsy during endoscopy to exclude malignancy

Question 8

The risk of bleeding from a peptic ulcer is increased with the use of what?

Answer 8

• NSAIDs
• Aspirin
• Anticoagulant
• Steroids
• SSRI (selective serotonin reuptake inhibitors) antidepressants

Question 9

Differential diagnosis?

Answer 9

• Chronic gastritis
• Atrophic gastritis
• Crohn’s disease

Question 10

Complications?

Answer 10

• Bleeding from the ulcer
• Perforation (a hole)
• Scarring

Question 11

Management?

Answer 11

• Stopping NSAIDs
• Treating H.pylori infections (if positive)
• Proton pumps inhibitors (lansoprazole or omeprazole) —> medications that works by reducing the amount of stomach acid made by glands in the lining of your stomach.