Peptic Ulcer Disease

Question 1

Types of Peptic Ulcer?

Answer 1

Gastric and Duodenal.

Question 2

Common Presentation?

Answer 2

Abdominal pain, Dyspepsia (indigestion), Nausea/Vomiting, Weight Loss/anorexia (malnutrition)

Question 3

Gastric Ulcer Specific signs?

Answer 3

Exacerbated by eating, Chest pain (heartburn), early onset (<2h post meal) + can lead to gastric cancer (elderly)

Question 4

Duodenal Ulcer Specific signs?

Answer 4

Relieved by eating, late onset (>2h post meal), night pain

Question 5

ALARMS symptoms for Cancer?

Answer 5

Patient > 55 AND:
Anaemia
Loss of Weight
Anorexia
Rapid onset
Melena/haematemesis
Swallowing difficulty (dysphagia)
2 week wait + Endoscopy.

Question 6

Investigations for Peptic Ulcers?

Answer 6

1) 2 week wait Referral (ALARMS)
2) H-pylori screen: Urea Breath Test + Stool Antigen
3) Review Medication e.g. NSAIDs, Steroids, PPI

Question 7

Management for Peptic Ulcers?

Answer 7

1) Triple Therapy - PPI, Amoxicillin + Clarithromycin

2) Smoking/alcohol cessation