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Peptic ulcer disease and gastritis

Peptic Ulcer Disease (PUD)

Definition:

  • PUD refers to open sores that develop on the inner lining of the stomach and upper portion of the small intestine. The most common types are gastric ulcers (in the stomach) and duodenal ulcers (in the duodenum).

Etiology:

  • Most commonly caused by Helicobacter pylori infection and prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Other factors: Smoking, alcohol, stress, and spicy foods.

Clinical Features:

  • Epigastric pain, often described as burning or gnawing, which may worsen at night or on an empty stomach.
  • Other symptoms include bloating, belching, nausea, or vomiting.
  • Complications: Gastrointestinal bleeding, perforation, and gastric outlet obstruction.

Diagnosis:

  • Endoscopy is the gold standard for diagnosis and allows for biopsy to test for H. pylori.
  • Urea breath test, stool antigen test, and blood serology can also detect H. pylori.
  • Imaging (e.g., X-ray with a barium swallow) can be used in certain cases.

Management:

  • Antibiotics for H. pylori eradication.
  • Proton pump inhibitors (PPIs) or H2-receptor antagonists for acid suppression.
  • Lifestyle modifications: Avoiding NSAIDs, reducing alcohol consumption, and quitting smoking.

Gastritis

Definition:

  • Gastritis is the inflammation of the stomach lining. It can be acute or chronic.

Etiology:

  • Causes include H. pylori infection, prolonged NSAID or alcohol use, stress, autoimmune disorders, and bile reflux.
  • Other factors: Ingestion of corrosive substances, infections, and certain foods.

Clinical Features:

  • Upper abdominal pain or discomfort.
  • Nausea, vomiting, and indigestion.
  • Chronic gastritis may be asymptomatic or may lead to ulcers or stomach cancer.

Diagnosis:

  • Endoscopy with biopsy for the definitive diagnosis.
  • Tests for H. pylori infection.
  • Blood tests to check for anemia, which can indicate chronic bleeding.

Management:

  • Similar to PUD: Eradication of H. pylori, use of PPIs, lifestyle adjustments.
  • Treatment depends on the specific cause (e.g., stop NSAIDs, treat autoimmune disorders).

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