Peptic ulcer disease Flashcards
And gastritis
What is a peptic ulcer?
A peptic ulcer is an open sore that develops on the inner lining of the stomach (gastric ulcer) or the upper part of the small intestine (duodenal ulcer).
What are the most common causes of peptic ulcers?
The most common causes are infection with Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
List 3 common symptoms of peptic ulcers.
Including associated symptoms
Burning or gnawing epigastric pain before (duodenal) or after (gastric) food, during night time,
Associated with bloating/early satiety, nausea/vomiting, melaena/bleeding.
May be relieved by antacids.
How is H. pylori infection diagnosed?
A breath test, stool test (antigen), blood test, or endoscopy with biopsy.
What are the primary treatment options for peptic ulcers? List 3.
Treatment includes antibiotics to eradicate H. pylori, proton pump inhibitors (PPIs) to reduce stomach acid, and lifestyle modifications.
Name two common proton pump inhibitors (PPIs) used in the treatment of peptic ulcers.
Omeprazole, lansoprazole and Esomeprazole.
What complications can arise from untreated peptic ulcers? List 3
Complications include bleeding, perforation, and gastric outlet obstruction.
What lifestyle changes can help prevent peptic ulcers?
Avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress.
How does H. pylori contribute to the development of peptic ulcers?
H. pylori damages the protective mucous lining of the stomach and duodenum, leading to inflammation and ulcer formation.
What is the role of endoscopy in the management of peptic ulcers?
Endoscopy is used to visualize the ulcer, take biopsies, and sometimes treat bleeding ulcers.
How do NSAIDs contribute to gastric ulcers?
NSAIDs inhibit cyclooxygenase (COX) enzymes, reducing prostaglandin production, which compromises the protective mucus layer of the stomach and duodenum.
Include aspirin
Lifestyle habits that increases the risk of developing gastric ulcers.
Smoking: Increases the risk of ulcer formation and impairs healing.
Alcohol consumption: Excessive intake can exacerbate mucosal damage.
Drugs: cocaine
Stress
Where do peptic ulcers usually occur?
Stomach - gastric,
Duodenum - duodenal
How might the symptoms of GORD differ from PUD?
GORD presents with heartburn, regurgitation, and chest pain, which may improve with proton pump inhibitors (PPIs).
Unlike PUD, GORD typically lacks the gnawing epigastric pain that improves with food.
Investigations for PUD and related conditions. (List 3)
- FBC - check for anaemia
- H. pylori testing
- Endoscopy - definitive but only if alarming symptoms present e.g. weight loss, dysphagia, malaena
Which vessel is often the main culprit of GI bleeding associated with PUD? Where is it?
Gastroduodenal artery. Crosses at first part of the duodenum.
What is gastric outlet syndrome? What is its predominant symptom with reference to its anatomy?
Scarring and narrowing of the pyloric channel from chronic ulceration/ tumour.
Presents with persistent vomiting and requires endoscopic or surgical management.
