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Peptic Ulcer Disease (Symptoms (Other symptoms (Heartburn, Tender…
Peptic Ulcer Disease
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Pathophysiology
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NSAIDs
Prostaglandins provide mucosal protection to the upper GI tract, so without them then NSAIDs irritate the stomach
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Aspirin can be enteric coated so it does not irritate the stomach. The coating comes off in the intestine
H.Pylori
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The bacteria releases chemicals that causes accumulation of neutrophil polymorphs leading to inflammation + ulceration
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Investigations
If >55 or ALARM symptoms, refer for endoscopy
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In patients <55 years or no ALARM symptoms, do a non invasive H.pylori test
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Treatment
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-ve H.Pylori
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After healing, NSAIDs can be continued only with PPI protection
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