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Peptic ulcers (Risk factors (Smoking, Drugs
(NSAIDs, SSRIs, steroids),…
Peptic ulcers
Risk factors
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Drugs
(NSAIDs, SSRIs, steroids)
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Clinical
presentation
Pain
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Exacerbating/relieving factors
Exacerbating - eating (gastric), before meals (duodenal),
certain foods (spicy etc)
Relieving - eating (duodenal), antacids
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Complications
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Gastric outflow obstruction
Oedema, scarring, Ca
Suction, fluids, PPIs, may need surgery
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Diagnosis
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Investigations
Bloods
FBC (anaemia), CRP, U+E, LFTs
H pylori
testing
Indications
Age <55y, symptomatic
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History
Smoking
Drugs
Red flags (weight loss, anaemia,
malaena, difficulty swallowing)
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Pathophysiology
H. pylori
Virulence factors
Increases acid secretion by increasing gastrin,
decreasing somatostatin, reduced duodenal bicarb
Parietal cell mass increased, mucus cells disrupted
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Management
Medical
H pylori treatment
Indication: H pylori +ve
PPI + 2 Abx (e.g. amoxicillin + clarithromycin,
or metronidazole + clarithromycin)
Confirm with FU H pylori test
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