ABSTRACT
The features of peptic ulcer disease include intermittent epigastric pain that can radiate to the back. The pain may start immediately after eating, but it usually starts 2 hours after eating. Because the pain often starts so long after eating, patients commonly think that the pain is brought about by not eating. This is why people complain of the so-called hunger pain. In reality, you cannot tell if an ulcer is gastric or duodenal based on the time relationship between eating and the onset of pain. The pain of peptic ulcers tends to be worse with spicy foods, but is relieved by milk and alkalis. The best investigation for peptic ulcers is an upper GI endoscopy with multiple biopsies of the ulcer to exclude malignant transformation within these lesions. Management of peptic ulcers is conservative (avoid smoking, stress, NSAIDs and aspirin) and medical. The best medical management for increased acid secretion is by the use of proton pump inhibitors (PPIs). PPIs irreversibly inhibit the action of the hydrogen/potassium
use is withdrawn then ulcers can re-develop. Because of effective drugs, surgical intervention is rarely required for peptic ulcer disease.
