Peptic ulcer disease
Description
- Mucosal break >5 mm penetrating the muscularis mucosae in stomach or duodenum
- Result of an imbalance: aggressive factors (acid, pepsin) vs mucosal defence (mucus-bicarbonate, prostaglandins, blood flow)
| Duodenal ulcer | Gastric ulcer | |
|---|---|---|
| Site | Duodenal bulb | Antrum / lesser curve |
| *H. pylori* | Stronger association | Present, but less consistently |
| Acid output | Normal or high | Normal or low |
| Pain | Classically relieved by food, wakes at night, 2-3 h post-prandial | Worse with food -> weight loss |
| Malignancy | Essentially never | Must biopsy and confirm healing |
- **H. pylori is most strongly associated with duodenal ulcers**
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