The global incidence of peptic ulcer disease and its complications at the turn of the 21st century. Gastric and duodenal ulcers were classified as an independent nosologic entity in 1829 by the french physician j. History of helicobacter pylori, duodenal ulcer, gastric. Often, a doctor will combine several medications and therapies when treating an.
A duodenal or peptic ulcer is an open sore in the intestine wall. Difference between gastric and duodenal ulcers hrf. Approximately 500,000 new cases are reported each year, with 5 million people affected in the united states alone. The polypeptide hormone, gastrin does, however, appear to play subtle and multiple roles in enhancement of gastric acid secretion in duodenal ulcer. Perforated peptic ulcer kjetil soreide, kenneth thorsen, ewen m harrison, juliane bingener, morten h moller, michael oheneyeboah, jon arne soreide perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. Gastric ulcers are located in the stomach see figure 1. Karazin national university medical school internal medicine dept. Unlike duodenal ulcer, pain caused by gastric ulcer cannot be relieved by eating food. Duodenal ulcers classically present earlier than gastric ulcers, by around 20 years. Infection with bacteria called helicobacter pylori and longterm use of nonsteroidal antiinflammatory medications such as aspirin or ibuprofen advil, motrin are common contributing factors to duodenal ulcer formation.
Mar 22, 2018 the acidic gastric juice can trigger the formation of ulcer within the mucosa of esophagus, stomach and duodenum. Gastroduodenal ulcer definition of gastroduodenal ulcer by. In duodenal ulcers there is an oversecretion of acid whilst in gastric ulcers there is an impairment of mucosal protection rapid urease tests are considered the endoscopic diagnostic. Peptic ulcer disease is a common illness, affecting about 10% of men and 5% of women during their lifetimes. The duodenal ulcer is observed as single or multiple ulcer localized in duodenum only. Both gastric and duodenal ulcers relate to the corrosive action of pepsin and hydrochloric acid on the mucosa of the upper gastrointestinal tract. One of the commonest causes of both gastric and duodenal ulcers is helicobacter pylori h pylori infection. It usually remains for five to seven days and heals within two weeks with no scarring. Gastric and duodenal ulcers are two kinds of peptic ulcers. Ulcer formation is caused by infection with helicobacter pylori.
Gastroduodenal peptic ulcer perforation article pdf available in east african medical journal 863. Once the acute phase has passed, administer for 10 days. Recent trends in the occurrence of bleeding gastric and duodenal. Gastric and duodenal ulcer peptic ulcer stomach free 30. Peptic ulcer and other gastric and duodenal ulcers lecture in internal medicine for iv course students m. May 11, 2020 peptic ulcer disease usually involves the mucosal lining of stomach or duodenum first layer of the inner lining of the stomach or duodenum. When the peptic ulcer is located in the stomach, it is called a gastric. Pdf as recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. Recent evidence suggests that abnormalities in gastrin release and action may be influenced by participation of somatostatin. Surgical management of bleeding gastric and duodenal ulcer. Define peptic ulcer and identify the risk factors for its formation. Peptic ulcer disease comprises both gastric and duodenal ulcersdefects that.
Complications are encountered in 10%20% of these patients and 2%14% of the ulcers will perforate 2,3. A peptic ulcer on the inside of the stomach lining is a gastric. A gp will almost certainly suspect an ulcer when presented with the symptoms, but will confirm it with a gastroscope where a flexible camera is passed down the throat. Peptic ulcer disease usually involves the mucosal lining of stomach or duodenum first layer of the inner lining of the stomach or duodenum. Table 1 causes of gastroduodenal perforation nontraumatic traumatic gastric ulcer iatrogenic duodenal ulcer foreign body obstruction violence ischemia malignancy table 2 boey score and outcomes risk score mortality or morbidity or 1 8% 2.
Mar 23, 2017 the major cause for the formation of duodenal ulcer is the bacteria known as helicobacter pylori a. Knowledge of the mechanisms that lead to ulcer formation or to gastric cancer in. Ulcer pain may not correlate with the presence or severity of ulceration. Eradication heals most duodenal ulcers and greatly diminishes the risk of recurrent bleeding. Of those infected with h pylori, the lifetime prevalence is approximately 20%. Approximately 10% of the us population has evidence of a duodenal ulcer at some time.
A 59yearold patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. A person can have one or both types of ulcers at the same time. Introduction although duodenal ulcer is a common disease, concomitant existence of gastric and duodenal ulcers is relatively infrequent. This bacteria causes contamination in the body and due to which the duodenal ulcer takes birth. Psychological stress increases risk for peptic ulcer, regardless of.
Peptic ulcer is a hole or open sore in the lining of the stomach, duodenum beginning of the small intestine or oesophagus. These ulcers can cause different symptoms, depending on where they are. Most ulcers are caused by an infection from a bacteria or germ called h. Describe the pathophysiology and clinical manifestations of peptic ulcer.
Additionally, we used a network metaanalysis approach to combine the direct. An ulcer in the lining of the duodenum, the lower end of the esophagus, or the stomach usually along the lesser curvature. Duodenal ulcer appeared to burst on the scene in the late 19 th and early 20 th century. Gastric and duodenal ulcers are both types of peptic ulcers. They may occur at any age but develop most often in men between the ages of 25. Peptic ulcers may present with dyspeptic or other gastrointestinal symptoms, or may be initially asymptomatic and then present with complications such as. However, these same symptoms are also seen in of patients with non ulcer dyspepsia. This instrument produces very clear pictures that allow rapid diagnosis, and they can also take small samples to find out if the duodenal ulcer has been caused by. Duodenal ulcers are found at the beginning of the small intestine also called the small bowel known as the duodenum. The most likely explanation for his recurrent ulcer is.
Genetic factors play a role in the pathogenesis of ulcer disease. Further, none of the stomach or duodenal tissue samples from 33 patients undergoing clinical evaluation, but having no evidence of peptic ulcer disease, had hsv1 materials. Review open access diagnosis and treatment of perforated or. Patients suffering from gastric ulcer are placed on special diets and are advised to avoid foods that are creamy or milky e. The ulcer is known as peptic ulcer when gastric acidic juice causes ulcers within mucosa of stomach, esophagus and duodenum. In this article, we shall look at the clinical features, investigations and management of peptic ulcer disease. Difference between gastric and duodenal ulcer symptoms. Nov 06, 2012 gastric ulcer duodenal ulcer gnawing epigastric pain occurring 30 minutes to 1 hour after meals gnawing epigastric pain occurring 23 hours after meals aggravated by eating because acid secretion increase at meal time leads to weight loss relieved by food because the pyloric sphincter, at the junction of stomach and duodenum, closes upon eating to. In addition, a oneweek course of two antibiotics plus an acidsuppressing medicine will usually clear the h.
Peptic ulcer international journal pharmtech, research. A peptic ulcer is a defect in the gastric or duodenal mucosa that extends through the muscularis mucosa into the deeper layers of the wall. Overall, the incidence of duodenal ulcers has been decreasing over the past 34 decades. In peptic ulcer men than in women, but stomach ulcers affect women more frequently. History of helicobacter pylori, duodenal ulcer, gastric ulcer. Bland diet peptic ulcer the diet for peptic ulcers should be wellbalanced while eliminating foods that cause you repeated distress. A crater ulcer in the lining of the beginning of the small intestine duodenum. The normal gastrointestinal mucosa is protected by numerous defensive mechanisms, such as surface mucous secretion and hco3 ion release.
Other factors predisposing a person to ulcers include antiinflammatory medications and cigarette smoking. Approximately 2050% of duodenal ulcer patients report a positive family history. From the results above described, i feel inclined to separate the gastric ulcer from the duodenal ulcer as different entity. However, duodenal ulcer, gastric ulcer, gastric cancer, and atrophic gastritis are all manifestations of the same root cause, h. Foods that are more irritating to the stomach are often avoided for peptic ulcers. Pdf incidence of duodenal ulcers and gastric ulcers in a western. Individuals currently experiencing ulcers should be encouraged to avoid foods that exacerbate symptoms and. The difference between gastric and duodenal ulcer health. In the past, experts thought lifestyle factors such as stress and diet caused ulcers. Peptic ulcer disease in both types of peptic ulceration, gastric and duodenal, there is an imbalance between secretion and neutralization of secreted acid. Gastric and duodenal ulcers in adults clinical guidelines. Gastric ulcer duodenal ulcer gnawing epigastric pain occurring 30 minutes to 1 hour after meals gnawing epigastric pain occurring 23 hours after meals aggravated by eating because acid secretion increase at meal time leads to weight loss relieved by food because the pyloric sphincter, at the junction of stomach and duodenum, closes upon eating to.
The lifetime prevalence of developing ulcer disease in firstdegree relatives of ulcer patients is about three times greater than the general population. Thirty had gastric ulcers, 39 had duodenal ulcers, and 1 had both. However, these same symptoms are also seen in of patients with nonulcer dyspepsia. Management of perforated gastric and duodenal ulcers. Review open access diagnosis and treatment of perforated. Di saverio md introduction every year peptic ulcer disease pud affects 4 milion people around the world 1. The management of perforated gastric ulcers sciencedirect. Peptic ulcer disease merck manuals professional edition.
This bacteria hurts the mucus that protects the lining of your stomach and the first part of your small intestine the duodenum. If laparotomy is undertaken and a straightforward duodenal ulcer encountered, closure with an omental patch is wellestablished as the optimal procedure. Perforated duodenal ulcer after laparoscopic gastric. Gastric and duodenal ulcers are peptic ulcers, which are open sores in the lining of the digestive tract. Effects of gastroprotectant drugs for the prevention and treatment of. Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the japanese evidencebased clinical practice guideline for peptic ulcer disease. An etiologic approach to management of duodenal and gastric ulcers. An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer. A peptic ulcer is a sore thats on the inside of the stomach lining a gastric ulcer or the upper part of the small intestine a duodenal ulcer. Know the difference between gastric and duodenal ulcer.
As in the us, duodenal ulcer disease prevalence is linked to h pylori infection. Gastroduodenal ulcer definition of gastroduodenal ulcer. Ulcers, gastric and duodenal also peptic ulcers, a chronic disease characterized by the formation of ulcerations in the stomach or duodenal wall. The acidic gastric juice can trigger the formation of ulcer within the mucosa of esophagus, stomach and duodenum. Duodenal ulcer definition of duodenal ulcer by medical. A person may have both gastric and duodenal ulcers at the same time. Ulcers generally range between 3 mm and several centimeters in diameter.
The symptoms of gastric and duodenal ulcer are similar and include a gnawing, burning ache and hungerlike pain in the midupper abdomen, usually experienced from one to three hours after meals and several hours after retiring. Difference between a duodenal ulcer and gastric ulcer. About duodenal ulcers stomach ulcers an ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body. The discovery of helicobacter pylori had a further. Peptic ulcers may present with dyspeptic or other gastrointestinal symptoms, or may be initially asymptomatic and then present with complications such as hemorrhage or perforation. Oct 27, 2001 duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori.
Pdf peptic ulcer disease pud is the erosion of stomach or. Gastric and duodenal ulcers are breaks in the gastric and duodenal mucosa. Diagnosis and treatment of perforated peptic ulcer dr. Gastric ulcers cause hematemesis or vomiting of blood while duodenal ulcers cause melena or blood in the stool.
Difference between gastric ulcer and duodenal ulcer. Peptic ulcer disease american college of gastroenterology. Gastric ulcers that occur on the inside of the stomach duodenal ulcers that occur on the inside of the upper portion of your small intestine duodenum the most common causes of peptic ulcers are infection with the bacterium helicobacter pylori h. Knowledge of the mechanisms that lead to ulcer formation or to gastric.
Gastric and duodenal ulcer peptic ulcer stomach free. Clinical guidelines currently recommend that ppis are used as. Gastric and duodenal ulcers can be differentiated from the timing of. Ten ways to relieve stomach ulcers at home medical news today. In chronic condition depth can go to the submucosal layer and sometimes perforate the serosa. May 14, 2014 duodenal ulcer appeared to burst on the scene in the late 19 th and early 20 th century. A duodenal ulcer is usually caused by an infection with a germ bacterium called helicobacter pylori h. Stomach pain in duodenal ulcers can be relieved by eating. It could take a good time of 4 to 8 weeks for this ulcer to heal if we use corrosive solutions. Gastric and duodenal ulcergastric and duodenal ulcer peptic ulcer represent a circumscribed disruption of gastric or duodenal wall continuity, single. Gastric and duodenal ulcers article about gastric and.
The most discriminating symptom of pain awakening the patient from sleep between 123 a. Introduction peptic ulcer disease represents a serious medical problem. Interestingly, those at the highest risk of contracting peptic ulcer disease are those. Diagnosis and treatment of peptic ulcer disease and h. Perforated duodenal ulcer after laparoscopic gastric bypass. Duodenal and gastric ulcers and gastric cancer are common and serious diseases but occur in only a minority of people infected with helicobacter pylori. Pathophysiology of duodenal and gastric ulcer and gastric. This instrument produces very clear pictures that allow rapid diagnosis, and they can also take small samples to.
Today we know that stomach acids and other digestive juices help create ulcers. A gastric ulcer has a special diet while duodenal ulcers do not. Management of patients with gastric and duodenal disorder. Ulcer or peptic ulcer disease is defined as erosion of the gastric mucosa that is clinically. Also, i think that the gastric ulcer combined to the duodenal ulcer will be not quite same with the gastric ulcer alone in their etiology, if any at all. The pathogenesis of duodenal ulcer and the role of.
If a diagnosis of ulcer is probable, and the patient has frequent attacks requiring repeated treatment with antiulcer drugs or, in cases of complicated ulcers perforation or gastrointestinal bleeding treatment to eradicate h. Guidelines for the evaluation and management of a patient who presents with. Photograph of a peptic ulcer taken during an upper endoscopy. Perforated ulcers of the upper gastrointestinal tract are potentially complicated surgical emergencies. The term dyspepsia is used to describe a complex of upper gastrointestinal tract symptoms which are typically present for four or more weeks, including upper abdominal pain or discomfort, heartburn, acid reflux, nausea andor vomiting. A 4 to 8week course of acidsuppressing medication will allow the ulcer to heal. Stomach ulcers are also known as peptic ulcers, gastric ulcers, or duodenal.