Peptic ulcer disease pud is a common condition that both primary care providers and gastroenterologists encounter. The concept of acid in peptic ulcer disease, which was the basis of treatment of peptic ulcer was revolutionized by the discovery of h 2receptor antagonists, that led to the principle of acid suppression therapy for duodenal ulcer which followed decades of. Diagnosis and treatment of peptic ulcer disease and h. The role of endoscopy in the management of patients with peptic ulcer disease thisisoneofaseries of statementsdiscussingtheuseof gi endoscopy in common clinical situations. Peptic ulcer is an erosion of the gastric mucosa resulting from the digestive action of hydrochloric acid and pepsin. People who take nsaids such as aspirin and ibuprofen longterm or are infected with the bacteria h. Esophageal ulcer open sores or lesions in the lining of esophagus mostly occur in the lower end of esophagus causes associated with bad case of. Clinical presentation and diagnosis of peptic ulcer. Peptic ulcer disease is a condition in which there are painful sores or ulcers in the lining of the stomach or the first part of the. Peptic ulcers are defects in the gastric or duodenal mucosa that extend through the muscularis mucosae. Gastric ulcers, in the stomach, and duodenal ulcers, in the upper portion of the small intestine, occur most often. Peptic ulcer disease pud is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus.
Symptoms of peptic ulcer disease are variable and may include abdominal pain. Ulcers are caused by an infection of a bacterium known as helicobacter pylori or h. Peptic ulcer disease peptic ulcers are defined as erosions in the gastric or duodenalmucosa that extend through the muscularis mucosae. Ulcerations in the git involve mucosal erosions of more than 0. Peptic ulcer disease pud is an important cause of morbidity and health care costs. Pain is most common, often localized to the epigastrium and relieved by food or antacids.
Helicobacter pylori hp in patients with suspected peptic ulcer disease pud. The formation of peptic ulcers depends on the presence of gastric juice ph and the decrease in mucosal defenses. Normally, the lining of the stomach and small intestines can protect itself against strong stomach acids. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine duodenum.
If peptic ulcer forms in the stomach, it is termed as gastric ulcer, similarly if it forms in the duodenum a duodenal ulcer, and esophageal ulcer if it forms in the esophagus. Peptic ulcer disease represents a serious medical problem. A peptic ulcer stomach ulcer is a sore on the lining of your stomach or duodenum. Peptic ulcer disease symptoms, treatment, pathophysiology. Mucosal injury due to helicobacter pylori infection, nsaid use, zollingerellison syndrome multiple peptic ulcerations in stomach, duodenum and jejunum due to excess gastrin secretion by a tumor, ischemia, bile pancreatic juice reflux. Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or the first part of the small intestine, the duodenum. See overview of the complications of peptic ulcer disease. In addition, a oneweek course of two antibiotics plus an acidsuppressing medicine will usually clear the h. Aggressive factors include gastric juice including hydrochloric acid, pepsin, and bile salts refluxed from the duodenum, helicobacter pylori, and nonsteroidal antiinflammatory drugs. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. The possibility that the concentration of pepsinogen in the blood serum might be correlated with other measurable structural or functional characteristics was investigated in 2,262 men selected randomly at a large army induction center.
Peptic ulcer disease includes both gastric and duodenal ulcers which posed a major threat to the worlds population over the past two centuries with a high morbidity and mortality. Pharm, class of 2018 sop, china pharmaceutical university nanjing, jiangsu, chn 211198. Gastric and duodenal ulcers usually cannot be differentiated based on history alone, although some findings may be suggestive see ddx. An overview of history, pathogenesis and treatment of. Peptic ulcer can occur in various parts of the gastrointestinal tract. Apr 14, 2020 a duodenal ulcer is usually caused by an infection with a germ bacterium called helicobacter pylori h. Introduction diabetic foot ulcers are an injury to all layers of skin, necrosis or gangrene that usually occur on the soles of the feet, as a result of peripheral neuropathy or peripheral. To understand the basis etiology and pathogenesis of. A peptic ulcer is an open sore or raw area in the lining of the stomach or intestine. Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. Peptic ulcers are present in around 4% of the population.
Cigarette smoking, alcohol, rapid gastric emptying. Weak defense stress, drugs, smoking helicobacter pylori peptic ulcer disease. Nonsteroidal antiinflammatory drugs nsaids and helicobacter pylori h. H pylori 90% zollingerellison syndrome etiology h pylori 70% nsaids complications lesser curvature of stomach left gastric artery posterior wall of. Peptic ulcer disease pud has various causes however. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves. The role of endoscopy in the management of patients with. Historically, our understanding of the pathophysiology of peptic ulcer disease focused on abnormalities in the secretion of gastric acid and pepsin, and on. The most common causes of peptic ulcer disease pud are helicobacter pylori infection and use of nonsteroidal antiinflammatory drugs nsaids.
Peptic ulcer disease usually occurs in the stomach and proximal duodenum. Chronic or recurrent true peptic ulcers penetrating the muscularis mucosae usually present with abdominal pain. A peptic ulcer on the inside of the stomach lining is a gastric. Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone.
Knowledge about etiology in peptic ulcer is tenuous, as it is with many chronic noninfective diseases, and that concerning the influence of environment is far from. Patients were divided into two groups, those with primary n 19 and those with secondary n 17 peptic ulcer disease. Mar 25, 2020 peptic ulcer disease can involve the stomach or duodenum. Peptic ulcer, chap 7, diabetes, coronary thrombosis and the saccharine disease second edition 1969 j wright and sons ltd bristol 87112 7. Clinical study of peptic ulcer disease allied academies. Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices.
A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. Etiology, pathophysiology, diagnosis and management of. No single cause has been found for ulcers, but various causes are listed. Patients suffering from peptic ulcer diseases usually have a family history of the disease, particularly the development of duodenal ulcer which may occur below the age of 20. Epigastric pain is the most common symptom of both gastric and duodenal ulcers, characterized by a gnawing or burning sensation and that occurs after. Decreased mucosal defense against gastric acid is another cause. A study of the effect of saliva on the concentration of mucin in gastric juice and its possible relationship to the etiology of peptic ulcer gut 8. Symptoms of peptic ulcer disease depend on ulcer location and patient age. The clinical manifestations, diagnosis, and management of peptic ulcer disease are discussed in detail, separately. The frequency of peptic ulcer disease in other countries is variable and is determined primarily by association with the major causes of peptic ulcer disease. Peptic ulcer disease is a condition in which there are painful sores or ulcers in the lining of the stomach or the first part of the small intestine the duodenum.
Historically, our understanding of the pathophysiology of peptic ulcer disease focused on abnormalities in. Interestingly, those at the highest risk of contracting peptic ulcer disease are those generations born around the middle of the 20th century. The pathophysiology of peptic ulcer disease has centred on an imbalance between aggressive and protective factors in the stomach. Feb 21, 2017 peptic ulcer disease peptic ulcers are defined as erosions in the gastric or duodenalmucosa that extend through the muscularis mucosae. Jan 24, 2019 if peptic ulcer forms in the stomach, it is termed as gastric ulcer, similarly if it forms in the duodenum a duodenal ulcer, and esophageal ulcer if it forms in the esophagus. Learn more about the symptoms, causes, and treatment of peptic ulcers at webmd. In addition, apart from helicobacter pylori infection and nsaids, peptic ulcer disease may be caused by any of the following. The two major etiologic factors responsible for peptic ulceration are infection by the gramnegative gastric pathogen helicobacter pylori and the use of aspirin and nonsteroidal antiinflammatory drugs nsaids. Peptic ulcer is a break like a sore in the lining of the stomach or the upper part of the small intestine 1, with a diameter of at least 0. Peptic ulcers result from an imbalance between factors that can damage the gastroduodenal mucosal lining and defense mechanisms that normally limit the injury. The natural history of peptic ulcer ranges from resolution without intervention to the development of complications with the potential for significant morbidity and mortality, such as bleeding and perforation. Gastric and duodenal ulcers usually cannot be differentiated based on history. A duodenal ulcer is usually caused by an infection with a germ bacterium called helicobacter pylori h.
Peptic ulcers, also known as gastric ulcers or stomach ulcers, can cause abdominal discomfort and pain. The standards of practice committee of the american society for gastrointestinal endoscopy asge prepared this text. Peptic ulcer disease or simply peptic ulcer is the presence of ulcerations in the gastrointestinal tract, which is characterized by being acidic and extremely painful. The evolution of knowledge regarding etiopathogenesis of peptic acid disease from aciddriven disease to an infectious disease has opened up this topic for various. Peptic ulcer disease pud in children is relatively rare as compared with adults. Peptic ulcer disease curved, gram negative rod in antrum of stomach complications gastritis type b peptic ulcer disease gastric adenoma malt lymphoma h pylori. Feb 03, 2019 peptic ulcer is a chronic disease affecting up to 10% of the worlds population. Etiology, pathophysiology, diagnosis and management of diabetics foot ulcer fahrun nur rosyid keywords. Peptic ulcers are formed when the lining of any of these organs is corroded by the acidic digestive juices which are secreted by the stomach. Peptic ulcer disease pud is one of the most common diseases affecting the gastroinestinal gi tract.
This protocol may be used by general practitioners, family doctors, and nurses. Peptic ulcers are formed when the lining of any of these organs is corroded by the. A dull or burning pain in the stomach is the most common symptom. All peptic ulcers in patients younger than 10 years of age were secondary in nature. In preparing this guideline, a search of the medical. Protocol for diagnosis and treatment of peptic ulcer in. A peptic ulcer in the stomach is called a gastric ulcer. Descriptive epidemiology, risk factors, management and prevention. Alcohol, smoking, copd and corticosteroids use may exacerbate peptic ulcer disease and impair healing. Hostile factors no gastric acid, no peptic ulcer is a misconception.
An esophageal ulcer occurs in the lower part of your esophagus. The predominant causes in the united states are infection with helicobacter pylori and use of nonsteroidal anti. The etiology of peptic ulcer disease shows overwhelming evidence blaming smoking as highly correlating with the disease, as explained throughout this case study. A 4 to 8week course of acidsuppressing medication will allow the ulcer to heal. They newly began in around 53 million people in 2014. Duodenal ulcer the peptic ulcer having a sore on the upper part of small intestine causes h. Excessive nsaid use also accounted for nearly one third of. The global incidence of peptic ulcer disease and its complications at the turn of the 21st century. The estimated prevalence of peptic ulcer disease in the general population is 510%, but recent epidemiological studies have shown a decrease. Theyre usually formed as a result of inflammation caused by the bacteria h. A single center 9year experience shuching huang, 1,6 borshyang sheu, 2 shuicheng lee, 3 hsiaobai yang, 4,5 yaojong yang 1 backgroundpurpose. Peptic ulcer disease merck manuals professional edition. Etiology and treatment of childhood peptic ulcer disease.
Etiology of pud normal increased attack hyperacidity, zollinger ellison syndrome. Peptic ulcer disease peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or the first part of the small intestine, the duodenum. Frequencies 10% of the world population 611% in different sources men. The two major aetiologic factors responsible for peptic ulceration are infection by the gramnegative gastric pathogen helicobacter pylori and the use of aspirin and nonsteroidal antiinflammatory drugs nsaids. Clinical study of peptic ulcer disease peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine, called the duodenum. The pain is described as burning or gnawing, or sometimes as a sensation of hunger.
Peptic ulcer is an acidinduced lesion of the digestive tract that is usually located in the stomach or proximal duodenum, and is characterized by denuded mucosa with the defect extending into the submucosa or muscularis propria. Protocol for diagnosis and treatment of peptic ulcer in adults. Peptic ulcer disease including both gastric and duodenal ulcer form a substantial part of patients seeking surgical opinion worldwide. Etiology and treatment of childhood peptic ulcer disease in. Gastric and duodenal ulcers are both types of peptic ulcers. Excessive gastric acid secretion is only one factor in the pathogenesis of peptic ulcer disease. Lifetime prevalence 10% of americans develop pud 10% of er patients with abdominal pain diagnosed with pud prevalence decreasing over last 30yrs maletofemale ratio of pud 2. But many things can reduce this protective layer, allowing for ulcers to occur. Peptic ulcer disease can involve the stomach or duodenum.
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