This document summarizes key information about peptic ulcers, including their clinical features, investigations, and management. It describes the symptoms of duodenal ulcers such as epigastric pain worsened by an empty stomach, and of gastric ulcers such as pain after eating and weight loss. It outlines non-invasive and invasive investigations for ulcers and lists lifestyle changes, medications, and surgeries that can be used in management. These include quitting smoking, reducing stress, and using antacids, H2 blockers, proton pump inhibitors, or surgery for perforated ulcers or bleeding.

1. Maryam Jamilah Binti Abdul Hamid
082013100002
IMS Bangalore

2.  We should be able to identify clinical
features for peptic ulcer
 We should be able to know the investigation
in peptic ulcer
 We should be able to list the management in
patient with peptic ulcer.

3. Duodenal Ulcer
 Abdominal pain in the epigastric region
 Pain worsens when stomach is empty (usually 2-5
hours after a meal)
 11PM-2AM greatest acid secretion
 Feels better after eating/drinking but worsens 1
or 2 hours later
 Vomiting is rare unless pyloric stenosis is present

4. Gastric Ulcer
Pain after eating
Appetite changes (decrease)
Weight loss
Vomiting (after having a meal)

5.  NON-INVASIVE
-serology
-13C-urea breath tests
-faecal antigen test
 INVASIVE
-histology (biopsy)
-rapid urease tests
-microbiological culture

6. 1. Examination of blood
2. Examination of stool
3. Gastric function tests
4. Radiological Investigation
5. Endoscopy (diagnostic accuracy >95%)

8. Changing of lifestyle
 Quit smoking
 Hurry, worry, curry
 Eat slowly
 Take meditation programme or any programme to
release stress
 Don’t eat too much of spicy food
 Quit eating smoked food

9. Drugs/blocker for peptic ulcer
1. Antacids
2. H2- receptor blocking drugs
3. M3-muscarinic receptors blocking drugs
4. Proglumide
5. Omeprazole

10. 6. Sucralphate (basic aluminium salt of
sucrose octasulphate)
7. Antibiotic
8. Vagotomy

11.  Perforated peptic ulcer
 Gastrointestinal bleeding
 Coffee ground vomiting
 Gastric Outlet Obstruction

12.  AK JAIN, MEDICAL PHYSIOLOGY TEXT
BOOK, VOLUME 1, 3RD EDITION
 HARRISON’S VOLUME 2
 S DAS TEXTBOOK OF SURGERY

13. Thank you