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User:Mr. Ibrahem/Peptic ulcer disease

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Peptic ulcer disease
Other namesPeptic ulcer, stomach ulcer, gastric ulcer, duodenal ulcer
Deep gastric ulcer
Medical specialtyGastroenterology
General surgery
SymptomsUpper abdominal pain, belching, vomiting, weight loss, poor appetite[1]
ComplicationsBleeding, perforation, blockage of the stomach[2]
CausesHelicobacter pylori, non-steroidal anti-inflammatory drugs, tobacco smoking, Crohn disease[1][3]
Diagnostic methodBased on symptoms, confirmed by endoscopy or barium swallow[1]
Differential diagnosisStomach cancer, coronary heart disease, inflammation of the stomach lining, gallbladder inflammation[1]
TreatmentStopping smoking, stopping NSAIDs, stopping alcohol, medications[1]
MedicationProton pump inhibitor, H2 blocker, antibiotics[1][4]
Frequency87.4 million (2015)[5]
Deaths267,500 (2015)[6]

Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus.[1][7] An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer.[1] The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves with eating.[1] With a gastric ulcer, the pain may worsen with eating.[8] The pain is often described as a burning or dull ache.[1] Other symptoms include belching, vomiting, weight loss, or poor appetite.[1] About a third of older people have no symptoms.[1] Complications may include bleeding, perforation, and blockage of the stomach.[2] Bleeding occurs in as many as 15% of cases.[2]

Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs).[1] Other, less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease, and liver cirrhosis.[1][3] Older people are more sensitive to the ulcer-causing effects of NSAIDs.[1] The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow.[1] H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach.[1] Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder inflammation.[1]

Diet does not play an important role in either causing or preventing ulcers.[9] Treatment includes stopping smoking, stopping use of NSAIDs, stopping alcohol, and taking medications to decrease stomach acid.[1] The medication used to decrease acid is usually either a proton pump inhibitor (PPI) or an H2 blocker, with four weeks of treatment initially recommended.[1] Ulcers due to H. pylori are treated with a combination of medications, such as amoxicillin, clarithromycin, and a PPI.[4] Antibiotic resistance is increasing and thus treatment may not always be effective.[4] Bleeding ulcers may be treated by endoscopy, with open surgery typically only used in cases in which it is not successful.[2]

Peptic ulcers are present in around 4% of the population.[1] New ulcers were found in around 87.4 million people worldwide during 2015.[5] About 10% of people develop a peptic ulcer at some point in their life.[10] Peptic ulcers resulted in 267,500 deaths in 2015, down from 327,000 in 1990.[6][11] The first description of a perforated peptic ulcer was in 1670, in Princess Henrietta of England.[2] H. pylori was first identified as causing peptic ulcers by Barry Marshall and Robin Warren in the late 20th century,[4] a discovery for which they received the Nobel Prize in 2005.[12]

References

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  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 Najm WI (September 2011). "Peptic ulcer disease". Primary Care. 38 (3): 383–94, vii. doi:10.1016/j.pop.2011.05.001. PMID 21872087.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Milosavljevic T, Kostić-Milosavljević M, Jovanović I, Krstić M (2011). "Complications of peptic ulcer disease". Digestive Diseases. 29 (5): 491–3. doi:10.1159/000331517. PMID 22095016.
  3. ↑ 3.0 3.1 Steinberg KP (June 2002). "Stress-related mucosal disease in the critically ill patient: risk factors and strategies to prevent stress-related bleeding in the intensive care unit". Critical Care Medicine. 30 (6 Suppl): S362–4. doi:10.1097/00003246-200206001-00005. PMID 12072662.
  4. ↑ 4.0 4.1 4.2 4.3 Wang AY, Peura DA (October 2011). "The prevalence and incidence of Helicobacter pylori-associated peptic ulcer disease and upper gastrointestinal bleeding throughout the world". Gastrointestinal Endoscopy Clinics of North America. 21 (4): 613–35. doi:10.1016/j.giec.2011.07.011. PMID 21944414.
  5. ↑ 5.0 5.1 GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282. {{cite journal}}: |author= has generic name (help)CS1 maint: numeric names: authors list (link)
  6. ↑ 6.0 6.1 Wang, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M.; Bhutta, Zulfiqar A.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Chen, Alan Zian; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H.; Fraser, Maya S.; Fullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Hay, Simon I.; Huynh, Chantal; Johnson, Catherine O.; Kassebaum, Nicholas J.; Kinfu, Yohannes; Kulikoff, Xie Rachel (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281. {{cite journal}}: Unknown parameter |displayauthors= ignored (|display-authors= suggested) (help)
  7. ↑ "Definition and Facts for Peptic Ulcer Disease". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 2 April 2015. Retrieved 28 February 2015.
  8. ↑ Rao, S. Devaji (2014). Clinical Manual of Surgery. Elsevier Health Sciences. p. 526. ISBN 9788131238714. Archived from the original on 4 November 2019. Retrieved 10 September 2017.
  9. ↑ "Eating, Diet, and Nutrition for Peptic Ulcer Disease". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 20 March 2015. Retrieved 28 February 2015.
  10. ↑ Snowden FM (October 2008). "Emerging and reemerging diseases: a historical perspective". Immunological Reviews. 225 (1): 9–26. doi:10.1111/j.1600-065X.2008.00677.x. PMC 7165909. PMID 18837773.
  11. ↑ GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. {{cite journal}}: |author1= has generic name (help)CS1 maint: numeric names: authors list (link)
  12. ↑ "The Nobel Prize in Physiology or Medicine 2005". nobelprize.org. Nobel Media AB. Archived from the original on 12 May 2015. Retrieved 3 June 2015.
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