Gastroenterology & NutritionPending review

Peptic Ulcer Disease

An ulcer forms wherever acid and pepsin overwhelm the mucosa's protective defences, so the site, the trigger and the danger of bleeding all fall out of that single imbalance.

In a nutshell

Ulcers form when acid/pepsin overwhelm mucosal defence, most often because H. pylori or NSAIDs have weakened the protective barrier. The relationship to food tells you the site, and progressive erosion explains bleeding, perforation and obstruction as a spectrum of the same unhealed lesion.

Classic presentation

Epigastric burning pain, relieved by food and recurring at night in duodenal ulcer, or worsened by food with weight loss in gastric ulcer, in a patient taking NSAIDs or with H. pylori infection.

Key points

Think 'defence down', not just 'acid up': H. pylori impairs mucus/bicarbonate secretion, NSAIDs deplete protective prostaglandins.

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Educational content pending clinical review. Not medical advice.