Peptic Ulcer Disease (PUD)

Epigastric pain from injury to mucosa of esophagus, stomach, or duodenum caused by action of acid and pepsin. Different locations have different presentations, such as:

• Gastric ulcer: an injury to the stomach lining.
  • Pain on empty stomach or just after eating due.
  • "Coffee grounds" appearance of digested blood in stool.
• Duodenal ulcer: often from excess acid secretion.
  • Pain at night or 2-3 hours after eating.
  • Undigested blood in stool.

Complications of PUD include:

• Anemia due to chronic, slow bleed.
• Hypovolemia due to hemorrhage.
• Peritonitis due to leaking chyme.

Risk factors of PUD include:

• Inflammation in gut lowers mucosa protection.
• Chronic NSAID use lowers mucus production, raises acid production.
• H. Pylori infection ???
• Corticosteroid use raises acid secretion, lowers immune response/healing.
• Cigarette smoking lowers healing, lowers mucosa blood flow.
• Excess alcohol use ???
• Gastrin-secreting tumors raise acid production.