TY - CHAP M1 - Book, Section TI - Peptic Ulcer Disease and Gastritis A1 - Bogle, Angela M. A1 - Gratton, Matthew C. A2 - Tintinalli, Judith E. A2 - Ma, O. John A2 - Yealy, Donald M. A2 - Meckler, Garth D. A2 - Stapczynski, J. Stephan A2 - Cline, David M. A2 - Thomas, Stephen H. PY - 2020 T2 - Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e AB - Peptic ulcer disease is a chronic illness manifested by recurrent ulcerations in the stomach and proximal duodenum. Acid and pepsin are thought to be crucial to ulcer development, but the great majority of peptic ulcers are directly related to infection with Helicobacter pylori or NSAID use.1,2Gastritis is acute or chronic inflammation of the gastric mucosa and has various etiologies. Dyspepsia is continuous or recurrent upper abdominal pain or discomfort and may be caused by a number of diseases or may be functional.3 Uncomplicated peptic ulcer disease has an estimated incidence of 0.1% to 0.3% per year, and about 5% to 10% of people living in the Western world will experience a peptic ulcer at some point during their lives.2H. pylori infection, one of the main risk factors for peptic ulcer disease, is one of the most prevalent human infections in the world, affecting at least 50% of the world’s population.4 The age-adjusted prevalence of H. pylori infection is decreasing in industrialized countries, likely due to an improved standard of living and to the increased use of proton pump inhibitors and antimicrobial therapy.2,3 This may explain the decreasing incidence of peptic ulcer disease in the United States, but this may be partially offset by the widespread use of low-dose aspirin and NSAIDs.2 Currently, at least a fifth of peptic ulcer disease cases have been found to be H. pylori–negative, NSAID-negative, and aspirin-negative.2 Certain medical conditions such as Helicobacter heilmannii, cytomegalovirus infections, Behçet’s disease, Zollinger-Ellison syndrome, Crohn’s disease, and cirrhosis with portal hypertension may contribute to the development of peptic ulcers.2 Other risk factors include antiplatelet agents, psychological stress, older age, and African-American ethnicity.2,5 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1166533715 ER -