Master Peptic Ulcer Disease Assessment with Picmonic for Medicine

H. pylori is a bacteria that lives in the stomach and has been linked to the development of peptic ulcers. Despite this association, not everyone who is infected with H. pylori will develop an ulcer. Factors such as diet, environment, and genetic makeup influence a person’s response to the bacteria.

Prolonged exposure to NSAIDs can cause peptic ulcer disease. Patients who use these drugs regularly will inhibit the production of gastroprotective prostaglandins in their gastric mucosa through the inhibition of COX-1. Gastric bicarbonate production will decrease, leaving the mucosa more vulnerable to the damaging effects of hydrochloric acid.

A person’s lifestyle can greatly contribute to the development of peptic ulcers. For example, individuals experiencing stress, or those who consume beverages such as coffee or alcohol, cause an increase in hydrochloric acid secretion, which can lead to ulcerations. Patients with Zollinger-Ellison syndrome, a condition that causes hypersecretion of gastric acid, will also develop ulcers.

Though abdominal pain is a common complaint of patients with peptic ulcers, timing of the pain varies according to where the ulcer is located. Pain caused by a duodenal ulcer typically occurs 2 to 5 hours after a meal, and may radiate to the patient’s back. Gastric ulcers, however, can cause a burning pain more closely associated with meals, and may be relieved by vomiting.

Heartburn is a burning sensation in the chest, caused by gastric acid. Patients with peptic ulcer disease may notice this burning sensation at night when they are in a supine position. Elevating the head of the bed is recommended, as laying flat can worsen heartburn.

Upper GI bleeding related to ulcers can cause patients to have black, tarry stools. Patients should monitor their stool for signs of bleeding and report these changes to their healthcare provider immediately. Hematemesis or vomiting of blood may also occur.

Peptic ulcer disease can cause different changes in weight depending on the etiology. Gastric ulcers are associated with weight loss, since the pain with eating discourages people from eating. Duodenal ulcers however may be associated with weight gain, since the pain decreases with eating.

Patients with peptic ulcer disease, particularly a gastric ulcer, may lose their desire to eat or drink due to unrelieved pain in their abdomen. A decrease in food and fluid intake can cause constipation.

Duodenal ulcers are more common than gastric ulcers, and can occur in people of all ages.

Pain caused by a duodenal ulcer typically occurs 2 to 5 hours after a meal, because eating relieves the pain due to the buffering effect of food on the stomach acid. Pain is typically located in the mid-epigastric region and is described as burning or cramp-like.

Gastric ulcers cause a burning pain 1 to 2 hours after a meal, and pain is not relieved by eating. Pain from a gastric ulcer may be relieved by vomiting.