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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

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Gastric ulcer
Other Resources UpToDate PubMed

Gastric ulcer

Contributors: Sanah Ali, Desiree Rivera-Nieves MD, Khaled Bittar MD, Nishant H. Patel MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Gastric ulcer (stomach ulcer), a common form of peptic ulcer disease, is an ulceration occurring in the lining of the gastric mucosal membrane caused by stomach acid damage to the digestive tract. Prevalence is similar across men and women, with a slightly higher incidence in men. There is an increase in incidence and mortality with age.

Seventy percent of peptic ulcers are asymptomatic, and 60% of peptic ulcers heal spontaneously.

Gastric ulcers can be associated with Helicobacter pylori infection or ingestion of NSAIDs. Other risk factors include smoking, excessive alcohol consumption, steroids, and high-salt diet. Less common etiologies include ischemia in the setting of severe burns (Curling ulcer) and uncontrolled activation of parietal cells due to vagal stimulation via elevated intracranial pressure (Cushing ulcer).

Gastric ulcers may lead to hemorrhage, perforation, infection, or scar tissue if left untreated.

Codes

ICD10CM:
K25.9 – Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation

SNOMEDCT:
397825006 – Gastric ulcer

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Gastroesophageal reflux disease
  • Gastritis
  • Functional indigestion / dyspepsia or Drug-induced dyspepsia
  • Esophagitis, Drug-induced esophagitis, esophageal ulcer
  • Duodenitis, Duodenal ulcer
  • Variceal bleed / chronic liver disease
  • Inflammatory bowel disease (eg, Crohn disease, Ulcerative colitis), Diverticulitis, Colon cancer
  • Gastric cancer
  • Gastrinoma
  • Dieulafoy ulcer, arteriovenous malformation
  • Mallory-Weiss syndrome
  • Melena mimics (caused by iron supplements and medications containing bismuth, eg, Pepto-Bismol)
  • Biliary calculus, Acute cholecystitis, Biliary calculus
  • Pancreatitis (Acute pancreatitis and Chronic pancreatitis)
  • Superior mesenteric artery syndrome
  • Acute mesenteric ischemia
  • Acute coronary syndrome
  • Coronary artery disease
  • Behçet syndrome (vasculitis)

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:05/14/2017
Last Updated:08/31/2023
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Patient Information for Gastric ulcer
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Gastric ulcer
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A medical illustration showing key findings of Gastric ulcer : Abdominal pain, Nausea, Vomiting, Anorexia
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