Peptic ulcer disease: Difference between revisions
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[[ | [[Abdominal Pain#Epigastric]] | ||
Revision as of 01:47, 1 August 2011
Background
- Recurrent ulcerations in the stomach and proximal duodenum
- Majority of cases related to H. pylori or NSAID use
- H. pylori found in 30-40% of U.S. population
- NSAIDs inhibit prostaglandin synthesis (decreases mucus and bicarb production)
Diagnosis
- Burning epigastric pain
- May awaken pt at night (gastric contents empty)
- Abrupt onset of severe pain may indicate perforation
- Abrupt onset of back pain may indicate penetration into the pancreas
- The following symptoms are NOT associated w/ PUD:
- Postprandial pain, food intolerance, nausea, retrosternal pain, belching
Red Flags
- Age >55yr
- Unexplained weight loss
- Early satiety
- Persistent vomiting
- Dysphagia
- Anemia or GI bleeding
- Abdominal mass
- Persistent anorexia
- Jaundice
Work-Up
DDx