Duodenum, peptic ulcer disease

Peptic ulcer disease (PUD) is a disease in which ulceration occurs in the lower esophagus, stomach (along its lesser curvature), the duodenum, or jejunum. These are all areas concerned with digestion, hence the name peptic. The most prominent symptom is gnawing pain that is relieved by food and alkali, but worsened by alcohol and condiments. Painless periods of remission can occur even without treatment. 

Partial resections of the stomach and duodenum for peptic ulcer disease have disappeared over the past few decades because of the success of medical therapy. However these procedures remain an option for treatment of cancer in the distal stomach. 

PER/I prescription event monitoring see epidemiology, peptic ulcer A disease state characterized by ulceration, initially of the mucosa of the alimentary tract, caused by the action of pepsin and hydrochloric acid. It may be in the body of the stomach (gastric ulcer), the duodenum (duodenal ulcer), jejunum Oejunal ulcer especially in Zollinger-Ellison syndrome) or of the oesophagus (oesophageal ulcer ... 

Recurrent anastomotic ulcers when they occur are usually found on the jejunal side of the anastomosis (Fig. 5.8a). In patients who present with persistent or complex duodenal or anastomotic ulcer, especially if associated with diarrhoea, weight loss, and liver metastasis, Zollinger-Ellison syndrome should be suspected. The syndrome consists of recurrent intractable peptic ulcers caused by hypergastrinae-mia produced by gastrin-secreting tumours of the pancreas (75%) or duodenum (15%) (Hirschowitz 1997). Tumour localisation is critical to aid in the identification of patients with potentially respectable disease (Berg and Wolfe 1991). Twenty percent of patients have multiple endocrine neoplasia type I which includes parathyroid, pituitary, and adrenal tumours. 

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