Peptic Ulcer Disease: Types, Causes, Symptoms, Diagnosis and Treatment

This presentation provides an overview of peptic ulcer disease, including its types, causes, symptoms, diagnosis, and treatment options. It also covers the age group affected, differential diagnosis, and references for further reading.

PEPTIC ULCER DISEASE
What is peptic ulcer? Types of peptic ulcer
It can be defined as sores developing in the stomach
and intestinal lining, due to inflammation caused by
bacteria.
Esophageal ulcer- develops inside the esophagus
Gastric ulcer- develops inside the stomach
Duodenal ulcers0 develops in the duodenum, upper
part of small intestine
Causes of peptic ulcer Symptoms of peptic ulcer
• Helicobacter pylori bacteria (Chan et al., 2013)
• Smoking
• Alcohol consumption (Thorsen et al., 2013)
• Radiation therapy
• Frequent ibuprofen and aspirin use (NSAIDs)
• Stress
• Mild to severe abdominal pain from the navel till
the chest
• Nausea
• Dark or bloody stools
• Unexplained loss in weight
• Vomiting
• Indigestion
• Chest pain
• Ulcer bleeding (this is more common amid
individuals who are administered blood thinning
agents like aspirin, warfarin, and clopidogrel
(Plavix)
Age group affected
• Duodenal ulcer affects people aged
30-50 years
• The ulcers are most common in
females
• Gastric ulcers occur at a later stage in
life (after 60 years)
Differential diagnosis
• Stomach cancer
• Pancreatitis
• Cholecystitis (Lau et al., 2013)
• Biliary colic
• Referred pain
• Superior mesenteric artery syndrome
Diagnosis of peptic ulcer Treatment of peptic ulcer
• Upper gastrointestinal series- Patient drink a
thick liquid of barium and X-ray is conducted for
the small intestine, stomach and esophagus.
• Upper endoscopy- Tube with a camera is
inserted through the throat into the stomach
and small intestine for examining the region
containing ulcer, followed by its removal.
• Proton pump inhibitors are administered to
reduce the stomach acids
• Acid blockers such as, famotidine (Pepcid) and
ranitidine (zantac) are prescribed for lowering
ulcer pain and stomach acid
• Eradication therapy using pantoprazole
and clarithromycin, combined with
metronidazole or amoxicillin (Satoh et al., 2016)
• Fluid replacement therapy with crystalloids
• Direct oral anticoagulants (DOAC)
References
Chan, F. K., Ching, J. Y., Suen, B. Y., Tse, Y. K., Wu, J. C., & Sung, J. J. (2013). Effects of Helicobacter pylori infection on long-term risk of peptic ulcer
bleeding in low-dose aspirin users. Gastroenterology, 144(3), 528-535.
Lau, J. Y., Barkun, A., Fan, D. M., Kuipers, E. J., Yang, Y. S., & Chan, F. K. (2013). Challenges in the management of acute peptic ulcer bleeding. The
Lancet, 381(9882), 2033-2043.
Satoh, K., Yoshino, J., Akamatsu, T., Itoh, T., Kato, M., Kamada, T., ... & Murakami, K. (2016). Evidence-based clinical practice guidelines for peptic
ulcer disease 2015. Journal of gastroenterology, 51(3), 177-194.
Thorsen, K., Søreide, J. A., Kvaløy, J. T., Glomsaker, T., & Søreide, K. (2013). Epidemiology of perforated peptic ulcer: age-and gender-adjusted
analysis of incidence and mortality. World Journal of Gastroenterology: WJG, 19(3), 347.