Peptic Ulcers Flashcards
What is a peptic ulcer?
Ulceration of the mucosa in stomach or duodenum
What are the 2 types of peptic ulcer?
Gastric
Duodenal
Which peptic ulcer is more common?
Duodenal
What is the function of the mucous membrane in the stomach and duodenum?
It secretes mucus that coats the surface and forms a barrier that protects it from the stomach’s contents, particularly stomach acid and digestive enzymes.
It secretes bicarbonate into this mucus coating to neutralise the stomach acid.
What are the 2 key risk factors for peptic ulcers?
H.pylori
NSAIDS
What key risk factors can increase stomach acid and cause peptic ulcers? (5)
• Stress
• Alcohol
• Caffeine
• Smoking
Spicy foods
What can increase risk of bleeding from a peptic ulcer? (5)
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Aspirin
• Anticoagulants (e.g., DOACs)
• Steroids
• SSRI antidepressants
What are the non-specific symptoms of a peptic ulcer? (3)
• Epigastric discomfort or pain
• Nausea and vomiting
• Dyspepsia
What are some signs of an upper GI bleed? (4)
○ Haematemesis (vomiting blood)
○ Coffee ground vomiting
○ Melaena (black, tarry stools)
Fall in haemoglobin on a full blood count
How do you differentiate duodenal and gastric ulcers in terms of symptoms?
Gastric = eating worsens pain .: lose weight
Duodenal = eating improves pain then pain comes back 2-3 hours later .: weight is stable or increases
What is the main diagnostic imaging for peptic ulcers?
Endoscopy
What test is done during an endoscopy to check for h.pylori?
Rapid urease test (CLO test)
How is malignancy excluded in peptic ulcers?
Biopsy is taken during endoscopy
What are the 3 main aspects of treating peptic ulcers?
Stopping NSAIDs
Treat h.pylori
PPIs
How do you ensure a peptic ulcer is healed?
Repeat endoscopy at 4-8 weeks
