Is Peptic Ulcer Preceded By Gastritis?

Erosive gastritis can lead to peptic ulcer disease, which can cause gastrointestinal bleeding, anemia, and scarring. Gastric outlet obstruction (GOO) is a condition where scar tissue in the stomach narrows or blocks the openings at the bottom (pylorus), causing ulcers. Peptic ulcer pain is more centered in the upper abdomen, while gastritis pain is usually felt in the upper left portion of the abdomen.

Gastritis can cause erosions or shallow sores in the stomach lining, leading to deeper, larger open sores called ulcers forming in the upper digestive tract. Chronic gastritis may be preceded by episodes of symptomatic acute gastritis or present without prior warning with dyspepsia. H. pylori infection is strongly associated with chronic gastritis and is probably the main course of chronic inflammation in the gastric mucosa.

It is difficult to differentiate between gastritis and peptic ulcer disease as they share similar symptoms. Nearly all peptic ulcers are caused by either Helicobacter pylori infection or the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin. Helicobacter pylori infection causes chronic gastritis, which can progress to severe gastroduodenal pathologies, including peptic ulcer, gastric cancer, and other complications.

There are distinct reasons or conditions that may mediate gastric ulceration, such as infection from Helicobacter pylori. Consultation with a healthcare professional is essential for an accurate diagnosis and appropriate treatment.

How to differentiate between pud and gastritis?

Gastritis and peptic ulcer disease (PUD) affect up to 50% of adults in Westernized countries. Gastritis is a superficial erosion and inflammation of the gastric mucosa. It can be either acute or chronic. Peptic ulcers are deeper erosions and ulcerations that extend through the muscularis layer of the gastric or duodenal mucosa.

These disorders result from a disrupted balance between formation of caustic gastric acid and maintenance of the protective mucosal barrier that depends on secretion of bicarbonate, prostaglandins, and mucosal growth factors. In general, gastritis and gastric ulcers are associated with insufficient mucosal protection, whereas duodenal ulcers are associated with excess acid secretion.

Helicobacter pylori infection may be responsible for up to 95% of duodenal ulcers and 85% of gastric ulcers worldwide. The gram-negative spirochete bacteria, first linked to gastritis in 1983, disrupt the mucosal protective barrier, making it more vulnerable to acid damage and inciting an inflammatory response. The bacteria also reduce somatostatin production, leading to increased gastrin secretion and action. In the United States, H. pylori infection is a less prevalent cause of ulcers; nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common cause of gastric ulcers in the US. Other etiologies include irritants such as aspirin and steroids; anticoagulants; comorbid illnesses; severe physiologic stress including burns, sepsis, trauma, and major surgery; local trauma, such as nasogastric tube placement; genetic factors and hypersensitivity and autoimmune reactions.

Can gastritis lead to peptic ulcers?

Complications. Left untreated, gastritis may lead to stomach ulcers and stomach bleeding. Rarely, some forms of chronic gastritis may increase your risk of stomach cancer. This risk is increased if you have extensive thinning of the stomach lining and changes in the lining’s cells.

Tell your healthcare professional if your symptoms aren’t improving despite treatment for gastritis.

• Feldman M, et al., eds. Gastritis and gastropathy. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier
• 2021. clinicalkey. com. Accessed Dec. 3, 2021.
• Ferri FF. Gastritis. In: Ferri’s Clinical Advisor 2022. Elsevier
• 2022. clinicalkey. com. Accessed Dec. 3, 2021.
• Gastritis and gastropathy. National Institute of Diabetes and Digestive and Kidney Diseases. niddk. nih. gov/health-information/digestive-diseases/gastritis-gastropathy. Accessed Dec. 3, 2021.
• Overview of gastritis. Merck Manual Professional Version. merckmanuals. com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/overview-of-gastritis#. Accessed Dec. 3, 2021.
• Kellerman RD, et al. Gastritis and peptic ulcer disease. In: Conn’s Current Therapy 2021. Elsevier
• 2021. clinicalkey. com. Accessed Dec. 3, 2021.
• FDA drug safety communication: Possible increased risk of fractures of the hip, wrist and spine with the use of proton pump inhibitors. U. S. Food and Drug Administration. fda. gov/drugs/postmarket-drug-safety-information-patients-and-providers/fda-drug-safety-communication-possible-increased-risk-fractures-hip-wrist-and-spine-use-proton-pump. Accessed Dec. 14, 2021.
• Picco MF (expert opinion). Mayo Clinic. Jan. 9, 2022.

What is the difference between a gastric ulcer and a peptic ulcer?

What is a peptic ulcer?. A peptic ulcer is a sore on the lining of your stomach or the first part of your small intestine (duodenum). If the ulcer is in your stomach, it’s also called a gastric ulcer. If the ulcer is in your duodenum, it’s called a duodenal ulcer. Rarely, they can happen further down your intestine.

What causes peptic ulcers?. In the past, experts thought lifestyle factors, such as stress and diet, caused ulcers. Today, we know that stomach acids and other digestive juices help create ulcers. These fluids burn the linings of your organs.

H. pylori bacteria (Helicobacter pylori). Most ulcers are caused by an infection from a bacteria or germ called H. pylori. These bacteria hurt the mucus that protects the lining of your stomach and the first part of your small intestine (the duodenum). Stomach acid then gets through to the lining.

Does gastric lead to ulcer?

Normally, the lining of the stomach and small intestines can protect itself against strong stomach acids. But if the lining breaks down, the result may be:

Stomach ulcer. The stomach is the organ of the digestive system in which food travels from the esophagus and is further broken down before its nutrients are absorbed in the small intestine. It produces acid and various enzymes that break down food into simple substances. The inside wall of the stomach is protected from the acid and enzymes by a mucous lining. Ulcers are caused when there is an imbalance between the digestive juices produced by the stomach and the various factors that protect the lining of the stomach. Symptoms of ulcers may include bleeding. On rare occasions, an ulcer may completely erode the stomach wall. A major cause of stomach ulcers is the bacteria called Helicobacter pylori. Treatment regimens for ulcers caused this bacterium usually include medications to suppress the stomach acid as well as antibiotics to eradicate the infection.

Most ulcers occur in the first, inner surface, layer of the inner lining. A hole in the stomach or duodenum is called a perforation. This is a medical emergency.

Does gastric acid cause peptic ulcers?

At one time ulcers were believed to be the result of too much stomach acid. It is now known that the main factors that lead to ulcers are the bacteria H. pylori and non-steroidal anti-inflammatory drugs (NSAIDS).

Is pud the same as gastritis?

Gastritis is an umbrella term for multiple conditions that result in the inflammation of the stomach lining. There are two key types of gastritis, acute and chronic. Acute gastritis often occurs unexpectedly and suddenly, while chronic gastritis develops gradually over time. In rare cases, gastritis does result in the development of ulcers and increases the risk of developing stomach cancer. However, gastritis is generally harmless and can improve easily with proper and early treatment.

Peptic ulcer diseases, on the other hand, are open sores that form inside of your stomach lining (Gastric ulcers) and upper section of your small intestine (Duodenal ulcers).

Both disorders share a couple of similar causes. The two key factors of peptic ulcer disease and gastritis are H. Pylori bacterium and the consumption of non-steroidal anti-inflammatory drugs, NSAIDs, such as ibuprofen, aspirin, and other painkillers.

NSAIDs are often prescribed to relieve symptoms of painful periods, colds, sprains and strains, and headaches, among other chronic or general pain. However, they also inhibit a certain enzyme production that, on normal days, protects the duodenum and stomach lining from the stomach acid and inflammation.

What is the pathophysiology of peptic ulcers?

With peptic ulcers, there is usually a defect in the mucosa that extends to the muscularis mucosa. Once the protective superficial mucosal layer is damaged, the inner layers are susceptible to acidity. Further, the ability of the mucosal cells to secrete bicarbonate is compromised.

H. pylori is known to colonize the gastric mucosa and causes inflammation. The H. pylori also impairs the secretion of bicarbonate, promoting the development of acidity and gastric metaplasia.

Histopathology. Gastric ulcers are most commonly located on the lesser curvature, whereas duodenal ulcers are most common at the duodenal bulb. The ulcer is round to oval with a smooth base. Acute ulcers have regular borders, while chronic ulcers have elevated borders with inflammation. An ulcer extends beyond the muscularis mucosa.

What is the leading cause of peptic ulcer disease?

The most common causes of peptic ulcers are infection with the germ Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

Stress and spicy foods do not cause peptic ulcers. But they can make symptoms worse.

Symptoms. Many people with peptic ulcers don’t have symptoms. If there are symptoms, they may include:

• Dull or burning stomach pain. For some people, pain may be worse between meals and at night. For others, it may be worse after eating.
• Feeling of fullness or bloating.
• Belching.
• Heartburn.
• Nausea.

How to differentiate between gastric ulcer and duodenal ulcer?

The presentation of patients with symptoms consistent with dyspepsia or peptic ulcer disease, particularly duodenal ulcers, can vary significantly depending on the degree of disease progression and time when a patient seeks treatment. Most patients with peptic ulcer disease are asymptomatic, with dyspepsia being the most common symptom. The location of the disease can also be differentiated based on symptoms. Common signs and symptoms include pain associated with duodenal ulcers, which improves after meals, and pain associated with gastric ulcers, which generally intensifies after meals.

Patients who initially present with ulcer-related complications may present with symptoms suggestive of upper gastrointestinal bleeding, including melena, hematemesis, elevated BUN, and anemia of varying degrees in severity with associated fatigue. Patients with more alarming symptoms, such as anemia, melena, or hematemesis, which may represent perforation or bleeding, will likely require more invasive forms of evaluation.

Duodenal ulcers may occur in any age group, but are most commonly diagnosed in patients aged 20 to 45 and are more common in men than women. Most patients will have a history of presenting symptoms consistent with peptic ulcer disease (PUD) associated with a previous diagnosis of H. pylori and/or heavy NSAID use. Other elements to consider include smoking history, daily aspirin use, and history of GI malignancy.

Evaluation is necessary to establish a definite diagnosis and underlying etiology. In general, the diagnosis of peptic ulcer disease, specifically duodenal ulcers, can be made directly by the visualization of the ulcer on upper endoscopy.

What is the most likely cause of peptic ulcer?

The most common causes of peptic ulcers are infection with the germ Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

Stress and spicy foods do not cause peptic ulcers. But they can make symptoms worse.

Symptoms. Many people with peptic ulcers don’t have symptoms. If there are symptoms, they may include:

What causes a peptic ulcer?

The most common causes of peptic ulcers are infection with the germ Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

Stress and spicy foods do not cause peptic ulcers. But they can make symptoms worse.

Symptoms. Many people with peptic ulcers don’t have symptoms. If there are symptoms, they may include: