Gastric ulcer
Alerts and Notices
Synopsis
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 tear
- Melena mimics (caused by iron supplements and medications containing bismuth, eg, Pepto-Bismol)
- Biliary colic, cholecystitis, cholelithiasis
- Pancreatitis (acute and chronic)
- Superior mesenteric artery syndrome
- Acute mesenteric ischemia
- Acute coronary syndrome
- Coronary artery disease
- Behçet disease (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.Subscription Required
References
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Last Reviewed:05/14/2017
Last Updated:09/16/2020
Last Updated:09/16/2020