The Singapore Family Physician

Back to issue Vol 35 No. 1 - Gastrointestinal diseases

Gastritis and Peptic Ulcer Disease

Richard Guan
The Singapore Family Physician Vol 35 No 1 - Gastrointestinal diseases
13 - 18
1 March 2009
0377-5305
Gastritis is often used to describe dyspeptic symptoms when it is a histological diagnosis and usually asymptomatic. Peptic ulcer disease has been decreasing due to increased use of acid suppressant drugs and eradication of H.pylori. NSAID induced ulcer bleeding in elderly patients is however on the rise. H.pylori is a significant cause of both duodenal and gastric ulcers. Eradication of H.pylori infection is the key to ulcer healing and prevention of relapse. The usual cause for failure of H.pylori eradication is antibiotic resistance of the H.pylori strain to metromidazole. Peptic ulcer not caused by H.pylori are almost always caused by NSAIDs. Both barium meal and endoscopy are appropriate investigations for dyspepsia. various drugs such as PPI, H2 receptor antagonist, antacids, prostaglandin analogues and mucousal protective agents can be used to treat peptic ulcer. The complications of peptic ulcer are bleeding, perforation, peritonitis and gastric outlet obstruction.