Peptic ulcer disease

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Última revisión: 12 Feb 2025
Última actualización: 03 Nov 2023

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • abdominal pain
  • presence of risk factors
  • 'pointing sign'
Todos los datos

Otros factores de diagnóstico

  • epigastric tenderness
  • nausea or vomiting
  • early satiety
  • weight loss or anorexia
  • diarrhoea
  • symptoms of anaemia
  • gastrointestinal bleeding
  • hypotension or septic shock
  • succussion splash
Todos los datos

Factores de riesgo

  • Helicobacter pylori infection
  • non-steroidal anti-inflammatory drug (NSAID) use
  • smoking
  • increasing age
  • personal history of peptic ulcer disease
  • family history of peptic ulcer disease
  • patient in intensive care
  • rotating shift work
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • upper gastrointestinal endoscopy
  • Helicobacter pylori carbon-13 urea breath test or stool antigen test
  • FBC
Todos los datos

Pruebas diagnósticas que deben considerarse

  • fasting serum gastrin level
  • urine NSAID screen
Todos los datos

Algoritmo de tratamiento

Agudo

active bleeding ulcer

no active bleeding: Helicobacter pylori negative

no active bleeding: Helicobacter pylori positive

En curso

recurrent or refractory ulcers

Colaboradores

Consejeros especializados

Ian Beales, BSc, MD, FRCP, FEBG

Consultant Gastroenterologist

Clinical Associate Professor

Norwich Medical School

Department of Gastroenterology

Norfolk and Norwich University Hospital

Norwich

UK

Divulgaciones

IB declares that he has no competing interests.

Agradecimientos

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Kristle Lee Lynch, MD

Assistant Professor of Clinical Medicine

Division of Gastroenterology

Department of Medicine

Hospital of the University of Pennsylvania

University of Pennsylvania

Perelman School of Medicine

Philadelphia

PA

Divulgaciones

​​​​​KLL ​​​​declares that she has no competing interests.

Revisores por pares

Alexander C Ford, MBChB, MD, FRCP

Professor of Gastroenterology

Honorary Consultant Gastroenterologist

Leeds Institute of Medical Research at St. James's

University of Leeds

Leeds Gastroenterology Institute

Leeds Teaching Hospitals Trust

Leeds

UK

Biografía

ACF served on the National Institute for Health and Care Excellence (NICE) guideline committee for clinical guideline CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management.

Divulgaciones

ACF declares that he has no competing interests. ACF is an author of a Cochrane systematic review cited in this topic.

Editores

Celia Pincus

Section Editor, BMJ Best Practice

Divulgaciones

CP declares that she has no competing interests.

Jo Haynes

Head of Editorial, BMJ Knowledge Centre

Divulgaciones

JH declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

Divulgaciones

AM declares that he has no competing interests.

Julie Costello

Comorbidities Editor, BMJ Best Practice

Divulgaciones

JC declares that she has no competing interests.

  • Peptic ulcer disease images
  • Diferenciales

    • Oesophageal cancer
    • Stomach cancer
    • Gastro-oesophageal reflux disease (GORD)
    Más Diferenciales
  • Guías de práctica clínica

    • Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
    • Acute upper gastrointestinal bleeding in over 16s: management
    Más Guías de práctica clínica
  • Calculadoras

    Blatchford Score for Gastrointestinal Bleeding

    Rockall Score for Upper Gastrointestinal Bleeding

    Más Calculadoras
  • Folletos para el paciente

    Peptic ulcers

    Más Folletos para el paciente
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