Enfermedad ulcerosa péptica

Abstract

Peptic ulcer is a mucosal break of diameter 5mm or larger, reaching submucosal layer. H. pylori and non-steroidal anti-inflammatory drugs (NSAID) intake, are the main causes. Their incidence has fallen during last years, in parallel with the incidence of H. pylori and the improvement in the knowledge of NSAID's effects. Symptoms are unspecific. Predominant symptom is epigastric pain, however asymptomatic cases are possible and may appear like a complication of another disorder. Nowadays, diagnosis is mainly endoscopic, allowing both ulcer visualization and to take biopsy samples in order to discard H. pylori and malignancy. Digestive hemorrhage is the most frequent complication, its treatment requires: adequate staging, fluid management, proton pump inhibitors (PPIs) use and endoscopic therapy in ulcer recurrence in high-risk patients. Gastric-wall perforation and obstruction are other possible complications. The two pillars of peptic ulcer treatment are H. pylori eradication therapy and PPI treatment when necessary, according with ulcer location and etiology.