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Peptic Ulcer Disease (PUD) and Gastritis

Peptic Ulcer Disease

Background Knowledge ๐Ÿง 

Definition

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).

Aetiology

  • 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 ๐ŸŒก๏ธ

Symptoms

  • 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.

Investigations ๐Ÿงช

Diagnostic Tests

    • 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 ๐Ÿฅผ

    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 smoking cessation.

      Complications

      • Gastrointestinal bleeding
      • Perforation
      • Gastric outlet obstruction


      Gastritis

      Background Knowledge ๐Ÿง 

      Definition

      Inflammation of the stomach lining – can be acute or chronic.

      Aetiology

      • H. pylori infection
      • Prolonged NSAID or alcohol use
      • Stress
      • Autoimmune disorders
      • Bile reflux
      • Other factors: Ingestion of corrosive substances, infections, and certain foods.

      Clinical Features ๐ŸŒก๏ธ

      Symptoms

      • Upper abdominal pain or discomfort.
      • Nausea, vomiting, and indigestion.

      Investigations ๐Ÿงช

      Initial Tests

      • Blood tests to check for anaemia, which can indicate chronic bleeding.

      Diagnostic Tests

      • Endoscopy with biopsy for the definitive diagnosis.
      • Tests for H. pylori infection.

      Management ๐Ÿฅผ

      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).

      Complications

      • Chronic gastritis may be asymptomatic and may lead to ulcers or stomach cancer.

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