Clinical meaning
A peptic ulcer is an open sore in the lining of the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer). Ulcers form when the protective mucous barrier of the GI lining is damaged, allowing stomach acid to erode the tissue underneath. The two most common causes are infection with the bacterium Helicobacter pylori (H. pylori) and chronic use of NSAIDs (ibuprofen, naproxen, aspirin), which reduce protective prostaglandin production. Duodenal ulcers are more common and typically cause burning epigastric pain that improves with eating, while gastric ulcers cause pain that worsens with eating.
Exam relevance
Risk factors: - H. pylori infection (most common cause) - Chronic NSAID use (ibuprofen, aspirin, naproxen) - Smoking (impairs mucosal healing) - Excessive alcohol use - Stress (ICU patients — stress ulcers) - Family history of peptic ulcer disease - Older age
Diagnostics: - H. pylori testing: stool antigen test, urea breath test, or biopsy during endoscopy - CBC to check for anemia (chronic blood loss) - Stool guaiac test (occult blood) - Upper endoscopy (EGD) for direct visualization if alarm symptoms present - Monitor vital signs for signs of bleeding (tachycardia, hypotension)