Peptic Ulcer Disease

Peptic ulcer disease (PUD) refers to a group of disorders characterized by the erosion of the mucosal lining of the stomach and duodenum, leading to the formation of ulcers. These ulcers can cause significant morbidity and mortality if left untreated or poorly managed.

Causes and Risk Factors

The primary causes of peptic ulcer disease include:

• Helicobacter pylori (H. pylori) infection: A bacterial infection that disrupts the protective mucous layer of the stomach, allowing acid to come into contact with the epithelial lining.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Long-term use of NSAIDs can lead to gastric mucosal damage and ulcer formation.
• Stress: Physical stress, such as that caused by severe illness or injury, can increase the risk of developing peptic ulcers.
• Genetic predisposition: Family history may play a role in the development of peptic ulcer disease.
• Dietary factors: A diet high in salt, spicy foods, and caffeine may exacerbate symptoms of PUD.

Symptoms

The most common symptom of peptic ulcer disease is:

• Abdominal pain: Typically described as a burning or gnawing sensation in the upper abdomen, which may be relieved by eating or worsened by hunger.
• Nausea and vomiting: May occur, especially if the ulcer is bleeding or has perforated.
• Bloating and discomfort: Some individuals may experience bloating, belching, or discomfort after eating.
• Weight loss: Unintentional weight loss may occur due to decreased appetite or fear of eating.

Diagnosis

Diagnosis of peptic ulcer disease typically involves:

• Endoscopy: A flexible tube with a camera is inserted through the mouth to visualize the stomach and duodenum.
• Upper GI series: A barium swallow test that uses X-rays to visualize the upper digestive tract.
• Blood tests: To check for anemia, inflammation, or H. pylori infection.
• Stool tests: To detect the presence of H. pylori or blood in the stool.

Treatment and Management

Treatment of peptic ulcer disease typically involves:

• Antibiotics: To eradicate H. pylori infection, if present.
• Proton pump inhibitors (PPIs): To reduce stomach acid production and promote healing.
• H2 blockers: To decrease acid production in the stomach.
• Protective agents: Such as sucralfate or misoprostol, to protect the mucous lining of the stomach.
• Lifestyle modifications: Avoiding NSAIDs, quitting smoking, and managing stress may help alleviate symptoms.

Complications

If left untreated or poorly managed, peptic ulcer disease can lead to:

• Bleeding ulcers: Which can cause severe blood loss and require hospitalization.
• Perforation: A hole in the stomach or duodenum that can lead to peritonitis, an infection of the abdominal cavity.
• Obstruction: Narrowing of the stomach or duodenum due to scarring, which can cause vomiting and weight loss.
• Cancer: Long-term H. pylori infection has been linked to an increased risk of developing gastric cancer.