Peptic ulcer disease
Peptic ulcer disease (PUD) refers to open sores that appear on the mucous layer of the esophagus, stomach and duodenum (the upper part of the small intestine).
Peptic ulcers are separated into four groups depending on their location
Esophageal ulcers – these ulcers are usually located in the distal part of the esophagus and caused by the corrosive influence of stomach acid acting on the unprotected mucous membrane of the esophagus.
- The most common localization of those ulcers is the lesser curvature of the stomach;
- Ulcers located on the greater curvature are fairly uncommon; however, they have a much greater tendency for malignization;
- Ulcers of the pyloric part of the stomach are common in young people. What separates them from the rest is that they are fairly resistant to treatment and the pain that they produce is very rarely associated with meals. If this type of ulcer is left untreated for many years, it can lead to stenosis, which will prevent the food from leaving the stomach;
Duodenal ulcers – can occur in the duodenal bulb (part of the duodenum that is closest to the stomach); post bulbar region, proximal and distal parts of the duodenum. Dyspeptic symptoms are a lot less common for duodenal ulcer and the pain syndrome is slightly different, which will be described below.
Ulcers of Meckel’s diverticulum (a slight bulge in the ileum - distal part of the small intestine) - tend to progress rather quickly with the most common symptoms being pain and intestinal bleeding. Often perforation of the ulcer is the first symptom that occurs while the rest of the symptoms pass unnoticed.