Peptic Ulcer Disease (PUD) is a common cause of epigastric pain. Pathophysiology is due to discontinuation of the inner lining of the gastrointestinal (GI) tract due to gastric acid secretion or pepsin causing an ulcer. The ulcer extends into the muscularis propria layer of the gastric epithelium and usually occurs in the stomach or duodenum. Ulcers may extend to the lower esophagus, distal duodenum or jejunum. Helicobacter pylori testing is recommended for all patients and, if positive, treatment with a proton pump inhibitor (PPI) based triple therapy usually manages most symptoms
Symptoms that require further workup and evaluation
Common Causes of PUD include
Less common causes of PUD
History and Physical Exam
Treatment includes removing any offending agent, such NSAIDs and anti-secretory drugs, and treating H. pylori infection
Failed Medical Management and Surgical Treatment
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