Peptic Ulcers

Question 1

What are peptic ulcers

Answer 1

Break in the lining of the GASTRIC or DUODENAL MUCOSA

Question 2

RF peptic ulcers

Answer 2

Gastric peptic ulcer:
H-pylori, NSAIDs,
Zollinger ellison syndrome - gastrin secreting tumour

Duodenal peptic ulcer - MC:
H pylori

both - smoking alcohol

Question 3

Difference in presentation between different types of peptic ulcer

Answer 3

in gastric peptic ulcer, epigastric pain worsens with eating but better in between + Wt LOSS

whilst with duodenal peptic ulcer, epigastric pain is better when eating and worsens between meals + Wt GAIN

Question 4

DX Peptic ulcer

Answer 4

if no RED Flag present (55+ dysphagia, hematmesis, malena, anemia)

non invasive testing:
- Rapid Urease Test (H. pylori test)
Stool antigen test

Question 5

Peptic ulcer management

Answer 5

Treat underlying cause:
- stop NSAIDs

Eradicate H. pylori - CAP
Clarithromycin, Amoxicillin
PPI

Rescope 6-8 weeks later

Question 6

Complications of peptic ulcers

Answer 6

Haemorrhage
Perforation
Gastric outflow obstruction
Malignancy