Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- abdominal pain
- presence of risk factors
- 'pointing sign'
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
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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- upper gastrointestinal endoscopy
- Helicobacter pylori carbon-13 urea breath test or stool antigen test
- FBC
Pruebas diagnósticas que deben considerarse
- fasting serum gastrin level
- urine NSAID screen
Algoritmo de tratamiento
active bleeding ulcer
no active bleeding: Helicobacter pylori negative
no active bleeding: Helicobacter pylori positive
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.
Diferenciales
- Oesophageal cancer
- Stomach cancer
- Gastro-oesophageal reflux disease (GORD)
Más DiferencialesGuías 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 clínicaCalculadoras
Blatchford Score for Gastrointestinal Bleeding
Rockall Score for Upper Gastrointestinal Bleeding
Más CalculadorasFolletos para el paciente
Peptic ulcers
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad