Enfermedad ulcerosa péptica

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources

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Evidence last reviewed: 21 Mar 2026
Topic last updated: 30 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • dolor abdominal
  • presencia de factores de riesgo
  • "signo indicador"
Full details

Other diagnostic factors

  • sensibilidad a la palpación en epigastrio
  • náuseas o vómitos
  • saciedad temprana
  • pérdida de peso o anorexia
  • diarrea
  • síntomas de anemia
  • sangrado gastrointestinal
  • hipotensión o shock séptico
  • ruidos de sucusión
Full details

Risk factors

  • Infección por Helicobacter pylori
  • consumo de antiinflamatorios no esteroideos (AINE)
  • tabaquismo
  • mayor edad
  • antecedentes personales de enfermedad ulcerosa péptica
  • antecedentes familiares de enfermedad ulcerosa péptica
  • paciente en cuidados intensivos
  • trabajo por turnos rotativos
Full details

Diagnostic tests

1st tests to order

  • endoscopia del tracto gastrointestinal superior
  • Prueba de aliento con urea de carbono 13 de Helicobacter pylori o prueba de antígeno en heces
  • hemograma completo (HC)
Full details

Tests to consider

  • nivel de gastrina sérica en ayunas
  • prueba de detección de AINE en orina
Full details

Treatment algorithm

ACUTE

úlcera con sangrado activo

sin sangrado activo: negativo para Helicobacter pylori

sin sangrado activo: positivo para Helicobacter pylori

ONGOING

Úlceras recurrentes o refractarias

Contributors

Expert advisers

Ian Beales, BSc, MD, FRCP, FEBG

Consultant Gastroenterologist

Clinical Associate Professor

Norwich Medical School

Department of Gastroenterology

Norfolk and Norwich University Hospital

Norwich

UK

Disclosures

IB declares that he has no competing interests.

Acknowledgements

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

Disclosures

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

Peer reviewers

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

Biography

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.

Disclosures

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

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. Oct 2019 [internet publication].Full text

UK Health Security Agency. Helicobacter pylori in dyspepsia: test and treat. Jan 2025 [internet publication].Full text

Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.Full text  Abstract

National Institute for Health and Care Excellence. Acute upper gastrointestinal bleeding in over 16s: management. August 2016 [internet publication].Full text

Siau K, Hearnshaw S, Stanley AJ, et al. British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding. Frontline Gastroenterol. 2020;11(4):311-23.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Enfermedad ulcerosa péptica images

  • Differentials

    • Cáncer de esófago
    • Cáncer estomacal
    • Enfermedad por reflujo gastroesofágico (ERGE)
    More Differentials

  • Guidelines

    • Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
    • Acute upper gastrointestinal bleeding in over 16s: management
    More Guidelines

  • Calculators

    Puntuación de Blatchford para el sangrado gastrointestinal

    Puntuación de Rockall para la hemorragia digestiva alta

    More Calculators

  • Patient information

    Úlceras pépticas

    More Patient information
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