Peptic Ulcer Disease Flashcards
What mechanisms underlie development of peptic ulcers?
↓ mucosal defence
and/or
↑ gastric acidic
Where do most peptic ulcers occur?
Duodenum
4x more common than gastric ulcers
What is the most common cause of duodenal ulcers?
H Pylori
What is the commonest cause of gastric ulcers?
NSAIDs
The following describes a syndrome that can cause peptic ulcers. Name the syndrome.
Gastric acid hypersecretion caused by a gastrin-secreting neuro-endocrine tumour is called __?__ syndrome.
Zollinger-Ellison syndrome
True or false: Having blood group O may be a risk factor for development of peptic ulcers
True.
Blood type O is a risk factor for duodenal ulcers
How might a patient with peptic ulcers present?
Epigastric pain
Anaemia
Weight loss
Anorexia
Malaena/haematemesis
Feeling of fullness
What differentials should be considered alongside peptic ulcers?
- Oesophageal or gastric cancer
- GORD
- Gastroparesis
- Biliary colic
- Acute pancreatitis
- Coeliac disease
- IBS
- Pleuritic pain
How are peptic ulcers diagnosed?
Including investigations
Clinical history and exam may be convincing, but ultimately an OGD to visualise the ulcer is the most definitive.
Other investigations:
- H Pylori breath test
- H Pylori antigen stool test
- Biopsy (adenocarcinoma)
- FBC (microcytic anaemia)
- Fasting serum gastrin (Z-E syndrome)
How are peptic ulcers managed?
Lifestyle:
- ↓ alcohol and tobacco
Medical:
- H Pylori eradication: triple therapy
- PPI’s (lansoprazole) or H2 blockers (ranitidine)
Surgery:
- If perforated or heavy bleeding
You should be wary of what potential complications when treating a patient with peptic ulcers?
- Haemorrhage
Ulcers can erode into gastroduodenal artery - Gastric outlet obstruction
- Perforation
- Intractable pain
- Malignant transformation
How long do peptic ulcers take to heal?
4-8 weeks with PPI therapy
