https://youtu.be/QZhvJc7PCVI

Outline/Aetiology

Overview

• Peptic ulcer is ulceration of the mucosa of:
  • Gastric mucosa = stomach
  • Duodenal ulcer = duodenum
• Duodenal ulcers are more common

Pathophysiology

The stomach mucosa is prone to ulceration from:

• Breakdown of the protective layer of the stomach and duodenum
• Increase in stomach acid

The protective layer of the stomach comprised of mucus and bicarbonate secreted by the stomach mucosa

The protective layer can be disrupted:

• NSAIDs
• Steroids
• H.Pylori

Risk factors

• H.Pylori 🦠
  • Is often associated with the majority of peptic ulcers
    • 90% of duodenal
    • 70% of gastric
    • Causes
• Drugs 💊
  • NSAIDs
  • SSRIs
  • Corticosteroids
  • Bisphosphonates
• Zollinger-Ellison syndrome 👿
  • Rare
  • Excessive levels of gastrin → usually from a gastrin secreting tumour
    • Secretes gastrin like hormone - often leading to extensive ulceration
• Rare:
  • Zolinger Ellison syndrome
  • Increased ICP - CUSHING'S ULCER
  • Post severe burns - Curling ulcer

Presentation