Book contents
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- 1 Anesthesia management of the surgical patient
- 2 Nutrition
- 3 Preoperative testing
- 4 Chronic medications around the time of surgery
- 5 Ethical considerations in the surgical patient
- 6 Cardiovascular disease
- 7 Postoperative chest pain and shortness of breath
- 8 Perioperative management of hypertension
- 9 Perioperative pulmonary risk evaluation and management for non-cardiothoracic surgery
- 10 Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS)
- 11 Postoperative pulmonary complications
- 12 Peptic ulcer disease
- 13 Liver disease
- 14 Inflammatory bowel disease
- 15 Postoperative gastrointestinal complications
- 16 Disorders of red cells
- 17 Assessment of bleeding risk in the patient with no history of hemostatic problems
- 18 Surgical issues affecting patients with hemotologic malignancies
- 19 Prophylaxis for deep venous thrombosis and pulmonary embolism in surgery
- 20 Blood transfusion/preoperative considerations and complications
- 21 Prevention of surgical site infections
- 22 Medical care of the HIV-infected surgical patient
- 23 Fever and infection in the postoperative setting
- 24 Surgery in the patient with renal disease
- 25 Postoperative electrolyte disorders
- 26 Diabetes mellitus
- 27 Disorders of the thyroid
- 28 Disorders of the adrenal cortex
- 29 Disorders of calcium metabolism
- 30 Pheochromocytoma
- 31 Rheumatologic diseases
- 32 Cerebrovascular disease
- 33 Management of the surgical patient with dementia
- 34 Neuromuscular disorders
- 35 Perioperative management of patients with Parkinson's disease
- 36 Delirium in the surgical patient
- 37 Surgery in the elderly
- 38 Obesity
- 39 Depression
- 40 Substance abuse
- 41 Care of the peripartum patient
- Part II Surgical procedures and their complications
- Index
- References
12 - Peptic ulcer disease
Published online by Cambridge University Press: 12 January 2010
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- 1 Anesthesia management of the surgical patient
- 2 Nutrition
- 3 Preoperative testing
- 4 Chronic medications around the time of surgery
- 5 Ethical considerations in the surgical patient
- 6 Cardiovascular disease
- 7 Postoperative chest pain and shortness of breath
- 8 Perioperative management of hypertension
- 9 Perioperative pulmonary risk evaluation and management for non-cardiothoracic surgery
- 10 Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS)
- 11 Postoperative pulmonary complications
- 12 Peptic ulcer disease
- 13 Liver disease
- 14 Inflammatory bowel disease
- 15 Postoperative gastrointestinal complications
- 16 Disorders of red cells
- 17 Assessment of bleeding risk in the patient with no history of hemostatic problems
- 18 Surgical issues affecting patients with hemotologic malignancies
- 19 Prophylaxis for deep venous thrombosis and pulmonary embolism in surgery
- 20 Blood transfusion/preoperative considerations and complications
- 21 Prevention of surgical site infections
- 22 Medical care of the HIV-infected surgical patient
- 23 Fever and infection in the postoperative setting
- 24 Surgery in the patient with renal disease
- 25 Postoperative electrolyte disorders
- 26 Diabetes mellitus
- 27 Disorders of the thyroid
- 28 Disorders of the adrenal cortex
- 29 Disorders of calcium metabolism
- 30 Pheochromocytoma
- 31 Rheumatologic diseases
- 32 Cerebrovascular disease
- 33 Management of the surgical patient with dementia
- 34 Neuromuscular disorders
- 35 Perioperative management of patients with Parkinson's disease
- 36 Delirium in the surgical patient
- 37 Surgery in the elderly
- 38 Obesity
- 39 Depression
- 40 Substance abuse
- 41 Care of the peripartum patient
- Part II Surgical procedures and their complications
- Index
- References
Summary
Peptic ulcer disease is caused by defects in the gastrointestinal mucosa extending into the muscularis mucosa secondary to gastric acid and/or pepsin. Recent advances have provided a better understanding of peptic ulcer pathophysiology. The propensity for peptic ulcers is caused by the imbalance between digestive and protective factors. Since the discovery of the bacterium Helicobacter pylori, the medical management of peptic ulcer disease has changed dramatically. Most peptic ulcers fall into two etiologies: nonsteroidal anti-inflammatory drugs (NSAIDS) or H. pylori.
The clinical presentation of peptic ulcer disease is variable. Some patients with peptic ulcer disease have classic symptoms, while other patients may have ulcer symptoms and no identifiable ulcers (non-ulcer dyspepsia). Many patients with peptic ulcer disease have no symptoms.
Epidemiology
The annual incidence of peptic ulcer disease ranges from 0.1% to 0.3%. Several studies have shown the incidence of peptic ulcer disease in H. pylori-infected individuals to be about 1% per year, which is six to tenfold higher than H. pylori-negative individuals. Since the mid 1970s, the incidence of duodenal ulcer seems to be declining in the USA reflected by decreasing rate of hospitalization, surgery, and death. Rates of hospitalization for ulcer hemorrhage decreased slightly for duodenal ulcers but have increased for gastric ulcers. Death rates from peptic ulcer disease seem to be declining for younger men and increasing for the elderly. Estimates of ulcer prevalence must take into account the H. pylori status of the patient.
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- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 179 - 185Publisher: Cambridge University PressPrint publication year: 2006