Peptic ulcer disease PUD

Peptic ulcer disease
  • Facts:
    MCC of significant upper GI bleeding

    Type 1 (along lesser curvature of stomach)
    Type 2 (two ulcers, one gastric and the other duodenal)
    Type 3 (pre-pyloric ulcer)
    Type 4 (proximal gastroesophageal ulcer)
    Type 5 (anywhere)
  • History / PE:
    Abdominal pain
    Nausea, vomiting
  • Diagnosis:
    Upper endoscopy
  • Treatment:
    Non H. pylori peptic ulcer
    PPI (eg. omperazole) or H2 blocker (eg. ranitidine)

    Duodenal / H. pylori peptic ulcer
    Amoxicillin plus clarithromycin and PPI
  • Complications:
    Hemorrhage (most common complication)
    Gastric outlet obstruction (hypokalemic, hypochloremic metabolic alkalosis)
  • See Also:
    Gastroesophageal reflux disease (GERD)
  • Associated With:
    H. pylori infection
    Zollinger-Ellison syndrome

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August 5th 2010