Gastrointestinal Duct

Chapter 1

Abstract

Monjur Ahmed

required if endoscopic therapy fails.

1. Introduction

2. Epidemiology

3

Keywords: peptic ulcer disease, dyspepsia, H. pylori infection, peptic ulcer bleeding, endoscopic treatment of peptic ulcer bleeding

Peptic Ulcer Disease

Peptic ulcer disease (PUD) is one of the commonest diseases seen throughout the world. There are various risk factors for the development of peptic ulcer disease, but the most important ones are Helicobacter pylori infection and nonsteroidal antiinflammatory drugs (NSAIDs). Patients generally present with dyspepsia or peptic ulcer bleeding. Acid suppressant therapy, H. pylori eradication, and avoidance of nonsteroidal anti-inflammatory drugs are the cornerstones of treatment of peptic ulcer disease. Peptic ulcer bleeding could be life-threatening. It is managed by appropriate supportive care, intravenous proton pump inhibitor therapy, and endoscopic hemostasis. Transarterial embolization (TAE) and surgery are rarely

Peptic ulcer disease (PUD) is defined as the mucosal break of the upper gastro-

PUD affects about 4.5 million persons per year in the United States (US) and causes huge healthcare cost of about \$3.3. billion/year [4]. The prevalence of PUD varies with the prevalence of Helicobacter pylori (H. pylori) infection. In the United States, the seroprevalence of H. pylori infection varies with age: 16.7% in young age (20–29 years) group and 56.9% in older age (>70 years) group. It is also different among different ethnicities: non-Hispanic whites 26.2%, non-Hispanic blacks 52.7%, and Mexican Americans 61.6% [5]. In developing countries, the prevalence

intestinal tract due to acid peptic digestion resulting in ulcer formation which extends beyond the muscularis mucosae into the submucosa. Most commonly it occurs in the stomach and first part of the duodenum but can also occur in the distal esophagus, distal duodenum, and jejunum and in the Meckel's diverticulum with heterotrophic gastric mucosa [1]. The size of the ulcer varies from 5 mm to several centimeters. On the other hand, erosions are superficial, less than 5 mm in size, and limited to the mucosa. PUD is still one of the commonest disorders we encounter in our clinical practice. The term "peptic" comes from the hormone pepsin which plays an important role in causing mucosal break. Peptic ulcer (PU) bleeding is the most common cause of upper gastrointestinal bleeding in the western world [2] and results in significant morbidity, mortality, and healthcare costs [3]. PUD is a benign condition, is easily treatable by medical therapy, and rarely requires surgery.
