Risk Factor Modification in Patients with Peptic Ulcer Disease
Peptic ulcer disease (PUD) results from a defect in the gastric or duodenal mucosa and submucosa caused by an imbalance between injurious factors and defense mechanisms in the gastrointestinal (GI) tract. Typically, the most common etiology is an infection with Helicobacter pylori bacterium. Gastrinoma, inflammatory diseases, or medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) can also lead to gastritis and PUD. Environmental factors have also been implicated, but are less well elucidated. Prevention through avoidance of injurious factors is critical. Once PUD has occurred, treatments are targeted toward protecting the gastrointestinal tract with acid suppression and, avoiding further insults, while allowing for time to restore the integrity of the mucosa. If H. pylori infection is confirmed, then multi-antibiotic drug regimens are necessary for treatment of the resultant PUD.
KeywordsH. pylori Peptic ulcer disease Gastric ulcer Duodenal ulcer Gastritis Zollinger-Ellison syndrome Gastrin Proton pump inhibitors
- 2.Sonnenberg A. The burden of digestive diseases in the United States. Chapter 15: Peptic ulcer disease. In: Everhart JE, editor. US Dep Health Hum Serv Public Health Serv Natl Inst Health Natl Inst Diabetes Dig Kidney Dis Wash DC US Gov Print Off 2008 NIH Publ. 1994;09(6443):257–408.Google Scholar
- 4.Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743–800.CrossRefGoogle Scholar
- 16.Berna MJ, Hoffmann KM, Serrano J, Gibril F, Jensen RT. Serum gastrin in Zollinger-Ellison syndrome: I. Prospective study of fasting serum gastrin in 309 patients from the National Institutes of Health and comparison with 2229 cases from the literature. Medicine (Baltimore). 2006;85(6):295.CrossRefGoogle Scholar
- 25.Feldman RA. Epidemiologic observations and open questions about disease and infection caused by Helicobacter pylori. In: Helicobacter Pylori Mol Cell Biol. Wymondham: Horizon Scientific Press; 2001. p. 29–51.Google Scholar