Peptic Ulcer Disease & Gastritis

Question 1

What are the two types of peptic ulcers?

Answer 1

Gastric ulcer and duodenal ulcer

Duodenal ulcers are more common than gastric ulcers.

Question 2

What is the function of the mucosa in the stomach and duodenum?

Answer 2

Secretes mucus to protect from stomach acid and digestive enzymes

Bicarbonate in mucus neutralizes stomach acid.

Question 3

What factors can disrupt the mucus barrier and increase the risk of ulceration?

Answer 3

• Helicobacter pylori
• NSAIDs

These factors can lead to peptic ulcer disease.

Question 4

List the factors that can increase stomach acid.

Answer 4

• Stress
• Alcohol
• Caffeine
• Smoking
• Spicy foods

These factors may contribute to ulcer formation.

Question 5

What medications increase the risk of bleeding ulcers?

Answer 5

• NSAIDs
• Aspirin
• Anticoagulants (e.g., DOAC)
• Steroids
• SSRIs

These medications can exacerbate ulcer complications.

Question 6

What are common symptoms of peptic ulcers?

Answer 6

• Epigastric discomfort or pain
• Nausea and vomiting
• Dyspepsia

These symptoms are typical presentations of peptic ulcers.

Question 7

List the signs of an upper GI bleed.

Answer 7

• Haematemesis
• Coffee ground vomit
• Melaena
• Fall in haemoglobin

Chronic microscopic bleeding can lead to iron deficiency anemia.

Question 8

How does eating affect gastric and duodenal ulcers?

Answer 8

• Gastric ulcers: eating worsens pain
• Duodenal ulcers: eating relieves pain, followed by pain 2-3 hours later

Patients with gastric ulcers may lose weight due to fear of eating.

Question 9

What diagnostic methods are used for peptic ulcers?

Answer 9

• Endoscopy
• H. pylori test - rapid urease test (CLO test)
• Biopsy

Biopsy can help exclude malignancy.

Question 10

What is the first step in the management of peptic ulcers?

Answer 10

Stop NSAIDs

Discontinuation of NSAIDs is crucial in ulcer management.

Question 11

What is the treatment regimen for H. pylori infections?

Answer 11

• PPI + amoxicillin + (clarithromycin or metronidazole)
• If penicillin allergy: PPI + clarithromycin + metronidazole

PPIs are also part of the treatment strategy.

Question 12

What are the complications of peptic ulcers?

Answer 12

• Bleeding
• Perforation → peritonitis and acute abdominal pain
• Scarring and strictures → gastric outlet syndrome

Gastric outlet syndrome is characterized by early fullness, discomfort, distension, and vomiting.

Question 13

What are the symptoms of gastric outlet syndrome?

Answer 13

• Early fullness after eating
• Upper abdominal discomfort
• Abdominal distension
• Vomiting

Treatment may involve balloon dilatation or surgery.

Question 14

What is the follow-up procedure after ulcer treatment?

Answer 14

Repeat endoscopy at 4-8 weeks to ensure healing

This helps confirm the resolution of the ulcer.