RT Book, Section
A1 Bogle, Angela M.
A1 Gratton, Matthew C.
A2 Tintinalli, Judith E.
A2 Ma, O. John
A2 Yealy, Donald M.
A2 Meckler, Garth D.
A2 Stapczynski, J. Stephan
A2 Cline, David M.
A2 Thomas, Stephen H.
SR Print(0)
ID 1166533715
T1 Peptic Ulcer Disease and Gastritis
T2 Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260019933
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1166533715
RD 2024/04/20
AB Peptic  ulcer  disease  is  a  chronic  illness  manifested  by  recurrent  ulcerations  in  the  stomach  and  proximal  duodenum.  Acid  and  pepsin  are  thought  to  be  crucial  to  ulcer  development,  but  the  great  majority  of  peptic  ulcers  are  directly  related  to  infection  with  Helicobacter  pylori  or  NSAID  use.1,2Gastritis  is  acute  or  chronic  inflammation  of  the  gastric  mucosa  and  has  various  etiologies.  Dyspepsia  is  continuous  or  recurrent  upper  abdominal  pain  or  discomfort  and  may  be  caused  by  a  number  of  diseases  or  may  be  functional.3  Uncomplicated  peptic  ulcer  disease  has  an  estimated  incidence  of  0.1%  to  0.3%  per  year,  and  about  5%  to  10%  of  people  living  in  the  Western  world  will  experience  a  peptic  ulcer  at  some  point  during  their  lives.2H.  pylori  infection,  one  of  the  main  risk  factors  for  peptic  ulcer  disease,  is  one  of  the  most  prevalent  human  infections  in  the  world,  affecting  at  least  50%  of  the  world’s  population.4  The  age-adjusted  prevalence  of  H.  pylori  infection  is  decreasing  in  industrialized  countries,  likely  due  to  an  improved  standard  of  living  and  to  the  increased  use  of  proton  pump  inhibitors  and  antimicrobial  therapy.2,3  This  may  explain  the  decreasing  incidence  of  peptic  ulcer  disease  in  the  United  States,  but  this  may  be  partially  offset  by  the  widespread  use  of  low-dose  aspirin  and  NSAIDs.2  Currently,  at  least  a  fifth  of  peptic  ulcer  disease  cases  have  been  found  to  be  H.  pylori–negative,  NSAID-negative,  and  aspirin-negative.2  Certain  medical  conditions  such  as  Helicobacter  heilmannii,  cytomegalovirus  infections,  Behçet’s  disease,  Zollinger-Ellison  syndrome,  Crohn’s  disease,  and  cirrhosis  with  portal  hypertension  may  contribute  to  the  development  of  peptic  ulcers.2  Other  risk  factors  include  antiplatelet  agents,  psychological  stress,  older  age,  and  African-American  ethnicity.2,5