Peptic Ulcer

Peptic Ulcer is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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Basics

Description

  • Produced by breakdown in gastric or duodenal mucosal defenses
  • Imbalance exists between production of acid and ability of mucosa to prevent damage.

Etiology

  • Helicobacter pylori:
    • Gram-negative spiral bacteria that live in mucous layer
    • Responsible for 90–95% of duodenal ulcers and 80% of gastric ulcers
    • Increases antral gastrin production and decreases mucosal integrity
  • NSAIDs:
    • Interfere with prostaglandin synthesis
    • Lead to break in mucosa
  • Aspirin
  • Cigarette smoking
  • Alcohol
  • Severe physiologic stress
  • Hypersecretory states (uncommon)
  • Genetics (>20% have family history)

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