Peptic Ulcer Disease Flashcards
What is PUD?
Full thickness ulcerations of duodenal / gastric mucosa.
How do PUD ulcers form?
When exposure to acid + digestive enzymes overcomes mucosal defense mechanisms
What are the risk factors for PUD? (4 things)
- H pylori
- NSAIDs
- SSRIs
- Corticosteroids
What is stomach mucosa prone to ulceration from? (2 things)
- Breakdown of protective layer of stomach + duodenum
- Increase in stomach acid
What is the protective layer of the stomach comprised of? (2 things)
- Mucus
- Bicarbonate
What can the protective layer of the stomach be broken down by? (2 things)
- Medications (e.g steroids / NSAIDs)
- Helicobacter pylori
What can an increase in stomach acid be caused by? (5 things)
- Smoking
- Stress
- Caffeine
- Alcohol
- Spicy foods
What are the CF of PUD? (5 things)
- Epigastric discomfort / pain
- Nausea + vomiting
- Dyspepsia
- Bleeding –> haematemesis + coffee ground vomiting + melaena
- Iron deficiency anaemia (bc constant bleeding)
What does eating do to the epigastric pain of gastric VS duodenal ulcers?
Gastric ulcers = eating worsens pain
Duodenal ulcers = eating relieves pain (pain when hungry)
What is the best diagnostic test for PUD?
OGD endoscopy
What should be done during endoscopy for sus PUD? (2 things)
- Rapid urease test to check for H pylori
- Biopsy (to exclude cancer)
What is the management in H pylori NEGATIVE PUD?
PPI
What is the management in H pylori POSITIVE PUD?
Eradication therapy
(Triple therapy of PPI + 2 abx including amoxicillin)
What are the complications of PUD? (2 things)
- Perforation
- Bleeding
