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Peptic ulcer disease.

Kalyanakrishnan Ramakrishnan1, Robert C Salinas

  • 1Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. kramakrishnan@ouhsc.edu

American Family Physician
|October 25, 2007
PubMed
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Peptic ulcer disease, often caused by Helicobacter pylori or NSAIDs, requires prompt diagnosis and treatment. Management includes eradicating H. pylori, using proton pump inhibitors, and endoscopy for persistent symptoms or complications.

Area of Science:

  • Gastroenterology
  • Internal Medicine

Background:

  • Peptic ulcer disease (PUD) commonly affects the stomach and duodenum.
  • Key causes include Helicobacter pylori infection and nonsteroidal anti-inflammatory drug (NSAID) use.
  • Symptoms range from epigastric discomfort to weight loss.

Purpose of the Study:

  • To outline the diagnosis and management of peptic ulcer disease.
  • To differentiate treatment strategies based on patient age and alarm symptoms.
  • To detail the management of PUD complications.

Main Methods:

  • Clinical presentation and diagnostic criteria for PUD.
  • Treatment guidelines for H. pylori eradication and antisecretory therapy.
  • Indications for endoscopy and surgical intervention.

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  • Management protocols for PUD complications like bleeding, perforation, and obstruction.

    • Main Results:

    • Prompt endoscopy is recommended for older patients and those with alarm symptoms.
    • Discontinuation of NSAIDs is advised for affected patients.
    • A test-and-treat strategy for H. pylori is recommended for younger patients without alarm symptoms.
    • Proton pump inhibitors and endoscopic therapy are effective for bleeding ulcers.
    • Perforation and gastric outlet obstruction are rare but serious complications requiring surgical intervention.

    Conclusions:

    • Effective management of PUD involves addressing underlying causes like H. pylori and NSAID use.
    • Tailored treatment strategies, including endoscopy and medication, improve patient outcomes.
    • Surgical intervention is reserved for severe complications or refractory cases.