ULCER (Peptic Ulcer Disease)

Peptic ulcer Disease is defined as a disruption of the mucosal integrity of the stomach or duodenum leading to a local defect or excavation due to active inflammation by a variety of aetiology.

Ulcer occurs when the aggressive factors overwhelms the defensive factors.
The defensive factors help to maintain the normal physiology of the stomach.
It's pertinent to state that the aggressive factors actually makes the list of the known aetiology.
The causes / risk factors are:

1. Helicobacter pylori
2. NSAIDS
3. pepsin
4. Alcohol
5. Cigratte smoking
6. Prolonged fasting /starvation
7. Excessively spiced food.
8. Family history of PUD
9. Blood group O
   

Types of ulcer

1. Gastric or stomach ulcer
2. Duodenal ulcer
3. Stress ulcer(from accident or life events)
4. Curlings ulcer (ulcer from fire or gas burns)

Clinical presentation
1.Upper central abdominal pain

1. Poor apetite
2. Belching
3. Abdominal pain
   Investigations
4. Upper GI endoscopy : to determine for the presence of ulcer and determine if it is benign or malignant.
5. Barium Nealon the absence of GI endoscopy.
   Ancillary investigation won't be left out.

Treatment
Usually the treatment should last for about 6weeks.
Stop smoking
Stop alcoholism
Administer a PPI
H2 antagonist
Antacid.
Bismuth subsalicilate.

Complications

1. Intractability
2. Perforation
3. Upper GI bleeding
4. Penetration to pancreas
5. Gastric outlet obstruction
6. Malignant transformation

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