Peptic ulcer disease merck manuals professional edition. Factors associated with an increased risk of duodenal ulcers in the setting of nsaid use include history of previous peptic ulcer disease, older age, female sex, high doses or combinations of nsaids, longterm nsaid use, concomitant use of anticoagulants, and severe comorbid illnesses. Ct scan is one of the important diagnostic study to diagnose perforated ulcer. Alcohol, smoking, copd and corticosteroids use may exacerbate peptic ulcer disease and impair healing. A healthy diet for duodenal ulcer has low salt, bad fat content and sugar. Acute stress peptic ulcer cushing ulcer gastric, duodenal or esophageal ulcer arising in patients with intercranial injury or operation curling ulcer occuring mosty in the proximal duodenum and associated with severe burns and trauma 16. An ulcer in the lining of the stomach is called a gastric ulcer. A prospective study of alcohol, smoking, caffeine, and the risk of duodenal ulcer in men. What is the pathogenesis of peptic ulcer disease pud. There are different brochures called nonulcer dyspepsia functional dyspepsia, stomach ulcer gastric ulcer and acid reflux and oesophagitis. Mass eradication of h pylori is impractical because of the cost and the danger of generating antibiotic resistance, so we need to know how to target prophylaxis. Ct scan helps to identify the inflammatory changes of peritoneal tissue and fistula around the duodenum. Assessing the safety of drugs for the longterm treatment of peptic ulcers. The healthy diet for duodenal ulcer patients include fruits, veggies, grains, fat free dairy products, pasta, whole wheat bread, cereals, brown rice, beans, eggs, lean meats, fish, eggs, and poultry.
The two most common types of peptic ulcer are called gastric ulcers. Mass eradication of h pylori is impractical because of the cost and the danger of generating. Get a printable copy pdf file of the complete article. This study showed a strong correlation between chronic active gastritis and the presence of h. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves. Take a few minutes to learn more about duodenal ulcers, and to see why there is no need to continue suffering, or to. Gastric and duodenal ulcers are two kinds of peptic ulcers. Gastric and duodenal ulcers are types of peptic ulcer. Malignant degeneration of a chronic peptic duodenal ulcer is rarely observed, as compared with malignant changes in a peptic ulcer of the stomach. Gastric and duodenal ulcers are both types of peptic ulcers.
The pathophysiological and pharmacological basis of peptic. Gastric and duodenal ulcer or peptic ulcer disease pud. In patients with peptic ulcer disease, helicobacter pylori should be eradicated to assist in healing and to reduce the risk of gastric and duodenal ulcer recurrence. Nsai, aspirin, cortisone and cytotoxic drugs cigarette smoking. Ct scan is not of much help in diagnosing duodenal ulcer.
A crater ulcer in the lining of the beginning of the small intestine duodenum. They affect different parts of the digestive tract, but both can cause pain and discomfort, and serious complications if. Both gastric and duodenal ulcers relate to the corrosive action of pepsin and hydrochloric acid on the mucosa of the upper gastrointestinal tract. Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. A peptic ulcer is a sore on the lining of your stomach or the first part of your small intestine duodenum. Your duodenum is the first part of your small intestine, the part of your digestive system that food travels through straight after it leaves your stomach you can get an. Although the pathophysiology of gastric ulcer and duodenal ulcer is similar, there are dearly differences between the two groups. Between 10 and 15 percent of the worlds population suffers from peptic ulcer.
Gastritis and peptic ulcer disease nutrition guide for. Get a printable copy pdf file of the complete article 2. Pathophysiology of duodenal and gastric ulcer and gastric. Pathophysiology of duodenal and gastric ulcer and gastric cancer john calam, j h baron duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori. A prospective study of its prevalence and the effects of antibacterial and anticulcer treatment. Nearly all ulcers are caused by helicobacter pylori infection or nonsteroidal antiinflammatory drug nsaid use. Pdf a peptic ulcer is a sore on the lining of the stomach or duodenum. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine duodenum. Gastric versus duodenal ulcer although there is much overlap, symptoms of a gastric ulcer may be different than those of a duodenal ulcer. Knowledge of the mechanisms that lead to ulcer formation or to gastric. Peptic ulcer pu is defect in the gastrointestinal mucosa usually located in the stomach and duodenum, but it can develop in.
The symptoms of gastric and duodenal ulcer are similar and include a gnawing, burning ache and hungerlike pain in the midupper abdomen, usually experienced from. The primary symptoms of a duodenal ulcer are heartburn, severe stomach pain, unplanned weight gain, and a burning sensation felt at the back of the throat. Chronic or recurrent true peptic ulcers penetrating the muscularis mucosae usually present with abdominal pain. The most common causes of peptic ulcer disease pud are helicobacter pylori infection and use of nonsteroidal antiinflammatory drugs nsaids. Pathogenesis and therapy of gastric and duodenal ulcer disease. Symptoms most patients with peptic ulcer disease present with abdominal discomfort, pain or nausea. The clinical examination, interpretation of finding of. Acute ulcers and erosions present clinically with gastrointestinal bleeding or perforation. A free powerpoint ppt presentation displayed as a flash slide show on id.
Hamilton i, oconnor hj, wood nc, bradbury i, axon at. Frequencies 10% of the world population 611% in different sources men. If the ulcer is in your stomach, it is called a gastric ulcer. A duodenal ulcer is a sore that forms in the lining of the duodenum. A peptic ulcer is an erosion in a segment of the gastrointestinal mucosa, typically in the stomach gastric ulcer or the first few centimeters of the duodenum duodenal ulcer, that penetrates through the muscularis mucosae. However, these same symptoms are also seen in of patients with nonulcer dyspepsia. Peptic ulcer disease peptic ulcer disease appears to be a heterogeneous group of disorders having in common a hole in the gastroduodenal mucosa in the presence of gastric acid, but differing in the pathophysiology of ulcer ation. When the peptic ulcer is located in the stomach, it is called a gastric. Duodenal ulcers, which account for 80 percent of peptic ulcers, are more common in men than in women, but stomach ulcers affect women more frequently.
A 4 to 8week course of acidsuppressing medication will allow the ulcer to heal. Heterogeneity is the most important consideration in the pathophysiology of peptic ulcer disease. The pathophysiology of peptic ulcer disease springerlink. The relationship between basal and maximum acid output in normal subjects and. A peptic ulcer on the inside of the stomach lining is a gastric. Peptic ulcers are eroded areas in the lining of stomach and duodenum, which result in abdominal pain, possible bleeding, and other gastrointestinal symptoms.
Factors concerned with mucosal defense are relatively more important than aggressive factors such as acid and pepsin. A duodenal ulcer is usually caused by an infection with a germ bacterium called helicobacter pylori h. Healing and recurrence of duodenal ulcer after treatment with tripotassium dicitrato bismuthate tdb tablets or cimetidine. Peptic ulcer disease is when a defect develops in the mucous membrane of the stomach or duodenum, and this causes epigastric pain.
The global incidence of peptic ulcer disease and its complications at the turn of the 21st century. There are a host of healthy food items for a patient suffering from duodenal ulcer. Peptic ulcers are deeper erosions and ulcerations that extend through the muscularis layer of the gastric or duodenal mucosa. About 14%25% of gastric and duodenal ulcers are found to be associated with nsaid use 18. Interaction data and randomized trial with nsaids and h. In addition, a oneweek course of two antibiotics plus an acidsuppressing medicine will usually clear the h. Abc of the upper gastrointestinal tract pathophysiology of. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. Understanding the pathophysiology of peptic ulcer disease is at something of a crossroads. Duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori. No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis, and nonerosive reflux disease. 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. In the past, experts thought lifestyle factors such as stress and diet caused ulcers.
Duodenal ulcer with malignant degeneration annals of. The symptoms of a duodenal ulcer this is the most common type of ulcer. Gastric and duodenal ulcers usually cannot be differentiated based on history. Pdf pathogenesis and therapy of gastric and duodenal ulcer. The two most common types of peptic ulcer are called gastric ulcers and duodenal ulcers.
A duodenal ulcer is an ulcer that takes place in the lining in the part of the small intestine just beyond the stomach the duodenum. Ulcer usually gastric and duodenal ulcers relate to the corrosive action of pepsin and hydrochloric acid on the mucosa of the upper gastrointestinal tract. The lifetime prevalence of developing ulcer disease in firstdegree relatives of ulcer patients is about three times greater than the general population. The most important steps in diagnosis of duodenal ulcer is to consult a gastroenterologist. According to ewing 1, only 10 cases were observed up to 1940. Despite the decreasing frequency of helicobacter pyloriinduced peptic ulcers, peptic ulcer disease remains a major clinical problem partly because. Diagnosis and treatment of peptic ulcer disease and h.
Basal gastric secretion in patients with duodenal ulcer. Difference in relapse rates of duodenal ulcer after healing with cimetidine or tripotassium dicitrato bismuthate. Pathophysiology of peptic ulcer disease springerlink. An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer. The most discriminating symptom of pain awakening the patient from sleep between 123 a.
Is the hypersecretion observed in duodenal ulcer patients due to excessive vagal stimuli to the stomach. These ulcers can cause different symptoms, depending on where they are. They do this by passing a thin, flexible telescope down your gullet oesophagus. 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. Till the last decade it has been estimated that 95% of duodenal ulcer and 70% of gastric ulcer is attributed due to. Duodenal ulcers causes, symptoms, treatment and diet. Gastritis is a superficial erosion and inflammation of the gastric mucosa. Approximately 2050% of duodenal ulcer patients report a positive family history. Knowledge of the mechanisms that lead to ulcer formation or to gastric cancer in. Gastritis and peptic ulcer disease pud affect up to 50% of adults in westernized countries.
Pdf despite the decreasing frequency of helicobacter pyloriinduced peptic ulcers, peptic ulcer disease remains a major clinical problem. A peptic ulcer is a sore thats on the inside of the stomach lining a gastric ulcer or the upper part of the small intestine. Ulcer pain may not correlate with the presence or severity of ulceration. If the ulcer is in your duodenum, it is called a duodenal ulcer. Full text full text is available as a scanned copy of the original print version. Genetic factors play a role in the pathogenesis of ulcer disease. Campylobacter pyloridisassociated chronic active antral gastritis. About duodenal ulcers stomach ulcers an ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body. A duodenal ulcer is a type of peptic ulcer that occurs in the duodenum, the beginning of the small intestine.
Ulcers generally range between 3 mm and several centimeters in diameter. In this test a doctor or nurse looks inside your stomach and the first part of your small intestine duodenum. Other factors predisposing a person to ulcers include antiinflammatory medications and cigarette smoking. Gastroscopy endoscopy is the test that can confirm a duodenal ulcer. Peptic ulcer disease can involve the stomach or duodenum. Duodenal ulcer classic symptoms of a duodenal ulcer include burning, gnawing, aching, or hungerlike pain, primarily in the upper middle region of the abdomen below the breastbone the epigastric. This cycle results in an increasing inability of the duodenal bulb to neutralize acid. A peptic ulcer is a sore on the lining of the stomach or duodenum. An esophageal ulcer occurs in the lower part of your esophagus.