Peptic ulcer disease PUD

• 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:
  Melena
  Abdominal pain
  Hematemesis
  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
  NSAIDs
  Zollinger-Ellison syndrome