Peptic Ulcers and their Complications
Peptic ulcer disease (PUD) is an uncommon disorder of early life. Peptic ulceration of the stomach or duodenum is usually associated with abnormalities of the gastric mucosa such as gastritis and/or gastropathy. Gastritis and ulcers of the stomach and duodenum can be classified into either primary or secondary depending on their aetiologies. The majority of primary or unexplained peptic ulcers are the result of chronic inflammation caused by Helicobacter pylori infection. However, an increasing number of children with PUD without evidence of H. Pylori infection are now being seen. Rarely PUD is caused by hypersecretory states. Secondary ulceration occurs in response to acute stress from severe systemic illnesses such as sepsis, head injury, burns, and as sequelae to use of certain drugs. The prognosis for recovery from peptic ulcers is good as most patients will respond to treatment.
Keywords: Peptic ulcer disease, Complication, Helicobacter pylori, NSAIDs, Management.
2. Milosavljevic T, Kostić-Milosavljević M, Jovanović I, Krstić M. "Complications of peptic ulcer disease". Digestive Diseases 2011; 29 (5):491–3. doi:10.1159/000331517. .
3. Steinberg KP. "Stress-related mucosal disease in the critically ill patient: risk factors and strategies to prevent stress-related bleeding in the intensive care unit". Critical Care Medicine 2002; 30 (6 Suppl): S362–4. doi:10.1097/00003246-200206001-00005.
4. Wang AY, Peura DA. "The prevalence and incidence of Helicobacter pylori-associated peptic ulcer disease and upper gastrointestinal bleeding throughout the world". Gastrointestinal Endoscopy Clinics of North America 2011; 21 (4):613–35. doi:10.1016/j.giec.2011.07.011.
5. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet 2016; 388 (10053):1545–1602. doi:10.1016/S0140-6736(16)31678-6.
6. Wang, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M.; Bhutta, Zulfiqar A.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Chen, Alan Zian; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J.; et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053):1459–1544. doi:10.1016/s0140-6736(16)31012-1.
7. "Definition and Facts for Peptic Ulcer Disease". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 2 April 2015. Retrieved 28 February 2015.
8. Rao, S. Devaji. Clinical Manual of Surgery. Elsevier Health Sciences. 2014 p. 526. ISBN 9788131238714.
9. "Eating, Diet, and Nutrition for Peptic Ulcer Disease". National Institute of Diabetes and Digestive and Kidney Diseases. Archived from the original on 20 March 2015. Retrieved 28 February 2015.
10. Snowden FM. "Emerging and reemerging diseases: a historical perspective". Immunological Reviews. 2008; 225 (1):9–26. doi:10.1111/j.1600-065X.2008.00677.x.
11. GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963):117–71. doi:10.1016/S0140-6736(14)61682-2.
12. "The Nobel Prize in Physiology or Medicine 2005". nobelprize.org. Nobel Media AB. Archived from the original on 12 May 2015. Retrieved 3 June 2015.
13. Bhat S. SRB's Manual of Surgery. 2013; p. 364. ISBN 9789350259443.
14. Cullen DJ, Hawkey GM, Greenwood DC, Humphreys H, Shepherd V, Logan RF, Hawkey CJ. "Peptic ulcer bleeding in the elderly: relative roles of Helicobacter pylori and non-steroidal anti-inflammatory drugs". Gut. 1997; 41(4):459 62. doi:10.1136/gut.41.4.459.
15. Lanas A, Chan FK. "Peptic ulcer disease". Lancet.2017; 390(10094):613–624. doi:10.1016/S0140-6736(16)32404-7.
16. "Peptic Ulcer". Home Health Handbook for Patients & Caregivers. Merck Manuals. October 2006. Archived from the original on 28 December 2011.
17. Sung JJ, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment PharmacolTher. 2009; 29: 938-946.
18. Jang HJ, Choi MH, Shin WG, Kim KH, Chung YW. Has peptic ulcer disease changed during the past ten years in Korea? A prospective multi-center study. Dig Dis Sci. 2008; 53:1527-1531.
19. Aro P, Storskrubb T, Ronkainen J, Bolling-Sternevald E, Engstrand L, et al. Peptic ulcer disease in a general adult population: the Kalixanda study: a random population-based study. Am J Epidemiol, 2006; 163:1025-1034.
20. Christensen S, Riis A, Nørgaard M, Sørensen HT, Thomsen RW. Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study. BMC Geriatr. 2007; 7:8.
21. Paimela H, Paimela L, Myllykangas-Luosujärvi R, Kivilaakso E. Current features of peptic ulcer disease in Finland: incidence of surgery, hospital admissions and mortality for the disease during the past twenty-five years.Scand J Gastroenterol. 2002; 37:399-403.
22. Post PN, Kuipers EJ, Meijer GA. Declining incidence of peptic ulcer but not of its complications: a nation-wide study in The Netherlands. Aliment PharmacolTher. 2006; 23:1587-1593.
23. Kang JY, Elders A, Majeed A, Maxwell JD, Bardhan KD. Recent trends in hospital admissions and mortality rates for peptic ulcer in Scotland 1982-2002. Aliment PharmacolTher. 2006; 24:65-79.
24. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. 2002; 347:1175-1186.
25. Rothenbacher D, Brenner H. Burden of Helicobacter pylori and H. pylori-related diseases in developed countries: recent developments and future implications. Microbes Infect. 2003; 5:693-703.
26. Hudson N, Hawkey CJ. Non-steroidal anti-inflammatory drug associated upper gastrointestinal ulceration and complications. Eur J GastroenterolHepatol. 1993; 5:412-419.
27. Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet. 2002; 359:14-22.
28. Chan FK, To KF, Wu JC, Yung MY, Leung WK. Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial. Lancet. 2002; 359:9-13.
29. Hawkey CJ, Tulassay Z, Szczepanski L, van Rensburg CJ, Filipowicz-Sosnowska A. Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. Helicobacter Eradication for Lesion Prevention.Lancet. 1998; 352: 1016-1021.
30. Lochhead P, El-Omar EM. Helicobacter pylori infection and gastric cancer. Best Pract Res ClinGastroenterol. 2007; 21:281-297.
31. Robinson K, Argent RH, Atherton JC. The inflammatory and immune response to Helicobacter pylori infection. Best Pract Res ClinGastroenterol. 2007; 21:237-259.
32. Blaser MJ, Atherton JC. Helicobacter pylori persistence: biology and disease. J Clin Invest. 2004; 113:321-333.
33. Ford AC, Delaney BC, Forman D, Moayyedi P. Eradication therapy in Helicobacter pylori positive peptic ulcer disease: systematic review and economic analysis. Am J Gastroenterol. 2004; 99:1833-1855.
34. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. ClinMicrobiol Rev. 2006; 19:449-490.
35. El-Omar EM. Role of host genes in sporadic gastric cancer. Best Pract Res ClinGastroenterol. 2006; 20: 675-686.
36. Chakravorty M, Ghosh A, Choudhury A, Santra A, Hembrum J, et al. Interaction between IL-1ß gene promoter polymorphisms in determining susceptibility to Helicobacter pylori associated duodenal ulcer. Hum Mutat. 2006; 27:411-419.
37. Robinson K, Argent RH, Atherton JC. The inflammatory and immune response to Helicobacter pylori infection. Best Pract Res ClinGastroenterol. 2007; 21:237-259.
38. Allison MC, Howatson AG, Torrance CJ, Lee FD, Russell RI. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med. 1992; 327:749-754.
39. Russell RI. Non-steroidal anti-inflammatory drugs and gastrointestinal damage-problems and solutions. Postgrad Med J. 2001; 77:82-88.
40. McNulty CA, Lehours P, Megraud F. Diagnosis of Helicobacter pylori infection. Helicobacter 2011; 16(suppl 1):10e8.
41. NICE. Acute upper gastrointestinal bleeding: management. London: National Institute for Health and Care Excellence, 2012.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).