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Peptic ulcer

MedGen UID:
45384
Concept ID:
C0030920
Disease or Syndrome
Synonyms: Gastroduodenal Ulcer; Gastroduodenal Ulcers; Peptic Ulcer; Peptic Ulcers; Ulcer, Gastroduodenal; Ulcer, Peptic; Ulcers, Gastroduodenal; Ulcers, Peptic
SNOMED CT: Peptic ulcer disease (13200003); Peptic ulceration (13200003); PUD - Peptic ulcer disease (13200003); PU - Peptic ulcer (13200003); Peptic ulcer (13200003); Gastroduodenal ulcer (13200003)
 
HPO: HP:0004398
Monarch Initiative: MONDO:0004247

Definition

The term peptic ulcer refers to acid peptic injury of the digestive tract, resulting in mucosal break reaching the submucosa. Peptic ulcers are usually located in the stomach or proximal duodenum, but they can also be found in the oesophagus or Meckel's diverticulum. Infection with Helicobacter pylori and the use of non steroidal antiinflammatory drugs (NSAIDs) or aspirin are the main risk factors of both gastric and duodenal peptic ulcers. [from HPO]

Conditions with this feature

Multiple endocrine neoplasia, type 1
MedGen UID:
9957
Concept ID:
C0025267
Neoplastic Process
Multiple endocrine neoplasia type 1 (MEN1) includes varying combinations of more than 20 endocrine and non-endocrine tumors. Endocrine tumors become evident either by overproduction of hormones by the tumor or by growth of the tumor itself. Parathyroid tumors are the most common MEN1-associated endocrinopathy; onset in 90% of individuals is between ages 20 and 25 years with hypercalcemia evident by age 50 years; hypercalcemia causes lethargy, depression, confusion, anorexia, constipation, nausea, vomiting, diuresis, dehydration, hypercalciuria, kidney stones, increased bone resorption/fracture risk, hypertension, and shortened QT interval. Pituitary tumors include prolactinoma (the most common), which manifests as oligomenorrhea/amenorrhea and galactorrhea in females and sexual dysfunction in males. Well-differentiated endocrine tumors of the gastro-entero-pancreatic (GEP) tract can manifest as Zollinger-Ellison syndrome (gastrinoma); hypoglycemia (insulinoma); hyperglycemia, anorexia, glossitis, anemia, diarrhea, venous thrombosis, and skin rash (glucagonoma); and watery diarrhea, hypokalemia, and achlorhydria syndrome (vasoactive intestinal peptide [VIP]-secreting tumor). Carcinoid tumors are non-hormone-secreting and can manifest as a large mass after age 50 years. Adrenocortical tumors can be associated with primary hypercortisolism or hyperaldosteronism. Non-endocrine tumors include facial angiofibromas, collagenomas, lipomas, meningiomas, ependymomas, and leiomyomas.
Familial hypocalciuric hypercalcemia 3
MedGen UID:
322173
Concept ID:
C1833372
Disease or Syndrome
Any familial hypocalciuric hypercalcemia in which the cause of the disease is a mutation in the AP2S1 gene.
Familial hypocalciuric hypercalcemia 2
MedGen UID:
374447
Concept ID:
C1840347
Disease or Syndrome
Familial hypocalciuric hypercalcemia type II (HHC2) is an autosomal dominant disorder characterized by lifelong elevations of serum calcium concentrations with low urinary calcium excretion and normal circulating parathyroid hormone concentrations in most patients. Patients are generally asymptomatic (summary by Nesbit et al., 2013). For a general phenotypic description and a discussion of genetic heterogeneity of hypocalciuric hypercalcemia, see HHC1 (145980).
Gastrocutaneous syndrome
MedGen UID:
338154
Concept ID:
C1850899
Disease or Syndrome
A rare syndromic hyperpigmentation of the skin with characteristics of multiple lentigines and cafe-au-lait spots associated with hiatal hernia and peptic ulcer, hypertelorism and myopia. There have been no further descriptions in the literature since 1982.

Professional guidelines

PubMed

Kamada T, Satoh K, Itoh T, Ito M, Iwamoto J, Okimoto T, Kanno T, Sugimoto M, Chiba T, Nomura S, Mieda M, Hiraishi H, Yoshino J, Takagi A, Watanabe S, Koike K
J Gastroenterol 2021 Apr;56(4):303-322. Epub 2021 Feb 23 doi: 10.1007/s00535-021-01769-0. PMID: 33620586Free PMC Article
Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM
Am J Med 2019 Apr;132(4):447-456. Epub 2019 Jan 3 doi: 10.1016/j.amjmed.2018.12.009. PMID: 30611829
Chey WD, Leontiadis GI, Howden CW, Moss SF
Am J Gastroenterol 2017 Feb;112(2):212-239. Epub 2017 Jan 10 doi: 10.1038/ajg.2016.563. PMID: 28071659

Recent clinical studies

Etiology

Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber DG, Abu-Zidan FM, Campanile FC, Di Saverio S, Baiocchi GL, Casella C, Kelly MD, Kirkpatrick AW, Leppaniemi A, Moore EE, Peitzman A, Fraga GP, Ceresoli M, Maier RV, Wani I, Pattonieri V, Perrone G, Velmahos G, Sugrue M, Sartelli M, Kluger Y, Catena F
World J Emerg Surg 2020;15:3. Epub 2020 Jan 7 doi: 10.1186/s13017-019-0283-9. PMID: 31921329Free PMC Article
Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM
Am J Med 2019 Apr;132(4):447-456. Epub 2019 Jan 3 doi: 10.1016/j.amjmed.2018.12.009. PMID: 30611829
Narayanan M, Reddy KM, Marsicano E
Mo Med 2018 May-Jun;115(3):219-224. PMID: 30228726Free PMC Article
Yegen BC
Curr Pharm Des 2018;24(18):2034-2040. doi: 10.2174/1381612824666180510092303. PMID: 29745325
Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA
Lancet 2015 Sep 26;386(10000):1288-1298. doi: 10.1016/S0140-6736(15)00276-7. PMID: 26460663Free PMC Article

Diagnosis

Vakil N
Gastrointest Endosc Clin N Am 2024 Apr;34(2):217-229. Epub 2023 Sep 22 doi: 10.1016/j.giec.2023.09.003. PMID: 38395480
Tarasconi A, Coccolini F, Biffl WL, Tomasoni M, Ansaloni L, Picetti E, Molfino S, Shelat V, Cimbanassi S, Weber DG, Abu-Zidan FM, Campanile FC, Di Saverio S, Baiocchi GL, Casella C, Kelly MD, Kirkpatrick AW, Leppaniemi A, Moore EE, Peitzman A, Fraga GP, Ceresoli M, Maier RV, Wani I, Pattonieri V, Perrone G, Velmahos G, Sugrue M, Sartelli M, Kluger Y, Catena F
World J Emerg Surg 2020;15:3. Epub 2020 Jan 7 doi: 10.1186/s13017-019-0283-9. PMID: 31921329Free PMC Article
Kempenich JW, Sirinek KR
Surg Clin North Am 2018 Oct;98(5):933-944. doi: 10.1016/j.suc.2018.06.003. PMID: 30243454
Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA
Lancet 2015 Sep 26;386(10000):1288-1298. doi: 10.1016/S0140-6736(15)00276-7. PMID: 26460663Free PMC Article
Jordan PH Jr, Morrow C
Surg Clin North Am 1988 Apr;68(2):315-29. doi: 10.1016/s0039-6109(16)44480-4. PMID: 3279549

Therapy

McGarvey C, Coughlan T, O'Neill D
J Am Geriatr Soc 2017 Jul;65(7):1566-1568. Epub 2017 Mar 6 doi: 10.1111/jgs.14840. PMID: 28263366
Baracat F, Moura E, Bernardo W, Pu LZ, Mendonça E, Moura D, Baracat R, Ide E
Surg Endosc 2016 Jun;30(6):2155-68. Epub 2015 Oct 20 doi: 10.1007/s00464-015-4542-x. PMID: 26487199
Narum S, Westergren T, Klemp M
BMJ Open 2014 May 15;4(5):e004587. doi: 10.1136/bmjopen-2013-004587. PMID: 24833682Free PMC Article
Harbison SP, Dempsey DT
Curr Probl Surg 2005 Jun;42(6):346-454. doi: 10.1067/j.cpsurg.2005.02.005. PMID: 15988415
Chan FK, Leung WK
Lancet 2002 Sep 21;360(9337):933-41. doi: 10.1016/s0140-6736(02)11030-0. PMID: 12354485

Prognosis

Yang P, Zheng Y, Zhang L, Hou X
Sci Rep 2021 Dec 8;11(1):23579. doi: 10.1038/s41598-021-00602-1. PMID: 34880278Free PMC Article
Wang A, Yerxa J, Agarwal S, Turner MC, Schroder V, Youngwirth LM, Lagoo-Deenadayalan S, Pappas TN
Curr Probl Surg 2020 Feb;57(2):100728. Epub 2020 Jan 7 doi: 10.1016/j.cpsurg.2019.100728. PMID: 32138833
Niv Y, Boltin D
Digestion 2012;86(3):258-63. Epub 2012 Oct 16 doi: 10.1159/000341423. PMID: 23075498
Khullar SK, DiSario JA
Gastrointest Endosc Clin N Am 1996 Jul;6(3):585-603. PMID: 8803569
Tytgat GN
Scand J Gastroenterol Suppl 1995;210:70-2. doi: 10.3109/00365529509090275. PMID: 8578212

Clinical prediction guides

Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SM, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY
N Engl J Med 2020 Apr 2;382(14):1299-1308. doi: 10.1056/NEJMoa1912484. PMID: 32242355
Falkeis-Veits C, Vieth M
Adv Exp Med Biol 2019;1149:121-134. doi: 10.1007/5584_2019_362. PMID: 31016630
Rahman SI, Saeian K
Crit Care Clin 2016 Apr;32(2):223-39. Epub 2016 Feb 12 doi: 10.1016/j.ccc.2015.12.002. PMID: 27016164
Venerito M, Goni E, Malfertheiner P
Expert Rev Gastroenterol Hepatol 2016;10(4):497-503. Epub 2016 Jan 5 doi: 10.1586/17474124.2016.1126507. PMID: 26619972
Aabakken L
Best Pract Res Clin Gastroenterol 2008;22(5):899-927. doi: 10.1016/j.bpg.2008.05.002. PMID: 18790438

Recent systematic reviews

Gisbert JP, Alcedo J, Amador J, Bujanda L, Calvet X, Castro-Fernández M, Fernández-Salazar L, Gené E, Lanas Á, Lucendo AJ, Molina-Infante J, Nyssen OP, Pérez-Aisa A, Puig I
Gastroenterol Hepatol 2022 May;45(5):392-417. Epub 2021 Oct 7 doi: 10.1016/j.gastrohep.2021.07.011. PMID: 34629204
Best LM, Takwoingi Y, Siddique S, Selladurai A, Gandhi A, Low B, Yaghoobi M, Gurusamy KS
Cochrane Database Syst Rev 2018 Mar 15;3(3):CD012080. doi: 10.1002/14651858.CD012080.pub2. PMID: 29543326Free PMC Article
Rice JB, White AG, Scarpati LM, Wan G, Nelson WW
Clin Ther 2017 Nov;39(11):2216-2229. Epub 2017 Oct 19 doi: 10.1016/j.clinthera.2017.09.011. PMID: 29055500
Sachar H, Vaidya K, Laine L
JAMA Intern Med 2014 Nov;174(11):1755-62. doi: 10.1001/jamainternmed.2014.4056. PMID: 25201154Free PMC Article
Narum S, Westergren T, Klemp M
BMJ Open 2014 May 15;4(5):e004587. doi: 10.1136/bmjopen-2013-004587. PMID: 24833682Free PMC Article

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