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Template:Peptic Ulcer Diease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  : Manpreet Kaur, MD [2]

Overview

Peptic ulcer disease results from the distruption of the normal epithelial lining of the walls of stomach and small intestine. The disrupted epithelium may sometimes be superimposed by Helicobacter pylori infection. Risk factors of peptic ulcer disease include ingestion of Non-Steroidal Inflammatory Drugs (NSAIDs), stress, .

• Helicobacter pylori-(previously called as Campylobacter pylori), gram-negative,helix-shaped, microaerophilic bacteria

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Causes

^ There is no life-threatening cause. Peptic ulcer disease may be caused by :

• Infections:
  • Bacteria:
    • Helicobacter pylori (60% gastric and 50-75% duodenal ulcers ) .
• Drugs-NSAIDs including aspirin{.Clopidogrel,spironolactone,sirolimus,bisphosphonates (when combined with NSAIDs),mycophenolate mofetil,spironolactone ,chemotherapy (hepatic infusion of 5 - fluorouracil ,selective serotonin reuptake inhibitors .
• Hormonal or mediator-induced including secondary acid hypersecretory states -Gastrinomas, systemic mastocytosis, carcinoid syndrome, myeloproliferative disorder, antral g - cell hyperfunction.
• Post-surgical -Antral exclusion and post gastric bypass surgery.
• Tumors-cancers and lymphoma
• Cameron ulcer (gastric ulcer where a hiatus hernia passes

through the diaphragmatic hiatus)

• True idiopathic ulcer

Rare causes of peptic ulcer disease

• Crohn’s disease of the stomach or duodenum
• Eosinophilic gastroduodenitis
• Systemic mastocytosis
• Radiation damage
• Viral infections (eg, cytomegalovirus or herpes simplex

infection, in particular in immunocompromised patients)

• Colonisation of stomach with H heilmanii
• Severe systemic disease

Genetic causes -

• Peptic ulcer disease is caused by gastrinomas (Zollinger-Ellison syndrome)caused by a mutation in MEN gene present on chromosome 11q13.

Causes by Organ System[edit | edit source] Cardiovascular No underlying causes Chemical/Poisoning No underlying causes Dental No underlying causes Dermatologic No underlying causes Drug Side Effecte serotonin reuptake -NSAIDs,Clopidogrel,spironolactone,sirolimus,bisphosphonates (when combined with NSAIDs),mycophenolate mofetil,spironolactone ,chemotherapy (hepatic infusion of 5 - fluorouracil ,selectivinhibitor Ear Nose Throat No underlying causes Endocrine- Environmental-smoking, excess alcohol consumption, caffeine intake ,more common in patients with Diabetes Mellitus ,hypertension ,metabolic syndrome. Gastroenterology -Crohn's disease, cirrhosis Genetic-Zollinger -Ellison syndrome associated with MEN TYPE 1 syndrome caused by mutation in MEN gene present on chromosome 11q 13 Hematologic No underlying causes Iatrogenic No underlying causes Infectious Disease-Helicobacter pylori (60% gastric and 50-75% duodenal ulcers ), Herpes simplex virus type 1, Cytomegalovirus, Helicobacter heilmannii, Tuberculosis, syphilis, and mucormycosis Musculoskeletal/Orthopedic No underlying causes Neurologic No underlying causes Nutritional/Metabolic No underlying causes Obstetric/Gynecologic No underlying causes Oncologic-non-beta cell tumor , carcinoid syndrome , gastrinomas Ophthalmologic No underlying causes Overdose/Toxicity No underlying causes Psychiatric- severe stress, depressed mood, suicidal ideation and psychological counseling Pulmonary-COPD, sarcoidosis Renal/Electrolyte-hypercalcemia Rheumatology/Immunology/Allergy- No underlying causes Sexual No underlying causes Trauma No underlying causes Urologic No underlying causes Miscellaneous No underlying causes Causes in Alphabetical Order[edit | edit source] List the causes of the disease in alphabetical order. Cause 1 Cause 2 Cause 3 Cause4 Cause 5 Cause 6 Cause 7 Cause 8 Cause 9 Cause 10 References[edit | edit source]

Pathophysiology

Pathogenesis

• The exact pathogenesis of [disease name] is not fully understood.

OR

• It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
• [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
• Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
• [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
• The progression to [disease name] usually involves the [molecular pathway].
• The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].