QUESTION 1: What is peptic ulcer disease?

Peptic ulcer disease is a condition where the lining of the stomach or duodenum has a defect extending through the muscularis mucosa, caused by acid and pepsin attacking and breaking down the protective barrier of the stomach and duodenal lining.

QUESTION 2: What age group is typically affected by peptic ulcer disease?

Peptic ulcer disease is a common illness in our country. Males are affected more than females, accounting for about 4/5 of all patients. The typical age of onset is from 20 to 40; however, the disease can also occur in people over 70 and children under 1 year old. Duodenal ulcers are more common than gastric ulcers (ratio 3/1 or 4/1).

QUESTION 3: What are the main causes of peptic ulcer disease?

1. First cause: Helicobacter pylori (HP) bacteria.

2. Second cause: use of non-steroidal anti-inflammatory drugs (NSAIDs), COX-2 inhibitors, and aspirin.

Other causes include: Lifestyle (alcohol, smoking), stress, excessive gastric acid secretion (Gastrinoma, G-cell hyperplasia of the antrum, Zollinger-Ellison syndrome), and genetic factors.

QUESTION 4: Is peptic ulcer disease dangerous?

Extremely dangerous. If not detected and treated promptly, the disease can be life-threatening, leading to complications such as gastrointestinal bleeding, ulcer perforation, or malignant transformation (cancer).

QUESTION 5: What are the symptoms of peptic ulcer disease?

* Typical presentation:

Patients experience epigastric pain. The pain has a cyclical nature throughout the day and year. Pain episodes usually begin suddenly. Daily pain follows a rhythm with meals or occurs when hungry and is relieved by eating (duodenal ulcer), or occurs a few hours after eating (gastric ulcer). This pain lasts for one or two weeks, then spontaneously resolves.

Pain-free periods last for many weeks or months, sometimes even a year. – Typically, the following year, in the cold season, a new pain episode as described above reappears.

Over time, the disease gradually loses its cyclical nature and rhythm with meals. Patients experience multiple pain episodes within a year, then it becomes continuous pain.

* Atypical presentation:

The disease progresses silently with no abdominal pain symptoms and presents abruptly with a complication such as gastrointestinal bleeding, ulcer perforation, or cancer.

QUESTION 6: What tests are used to detect peptic ulcer disease?

Gastroduodenal endoscopy is the gold standard for diagnosing peptic ulcer disease and detecting H. pylori bacteria (CLO test).

Barium X-ray of the stomach and duodenum: often used when the patient does not agree to endoscopy or is uncooperative during endoscopy.

Tests for Helicobacter pylori bacteria:

Urea breath test for HP: this is the most accurate test for HP infection with a sensitivity and specificity of 95%.

Rapid urease test (CLO test via endoscopy, biopsy of tissue samples).

Regular endoscopy should be performed to re-evaluate the ulcer.

Diagnostic imaging tests: abdominal ultrasound, CT-scan, MRI, etc.

CONCLUSION: Peptic ulcer disease is a very common condition in our country. If detected and treated early, the disease can be completely cured. If left undetected, the disease can lead to unpredictable complications. Do you suspect you have peptic ulcer disease? Please visit reputable medical facilities for early diagnosis and treatment!

Dr. Nguyen Van Thuan, Specialist Level I