Peptic ulcer causes: Difference between revisions

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==Overview==
==Overview==
Common causes of peptic ulcer disease include ''[[Helicobacter pylori]]'' infection and [[NSAID]] use.  Less common causes of peptic ulcer disease include Crohn's disease, [[Zollinger-Ellison syndrome]], [[Cushing]] and [[Curling ulcers]], Carcinoid tumors, and [[carcinoid syndrome]].  
Common causes of [[peptic ulcer]] disease include ''[[Helicobacter pylori]]'' infection and [[NSAID]] use.  Less common causes of [[peptic ulcer]] disease include [[Crohn's disease]], [[Zollinger-Ellison syndrome]], [[Cushing's Ulcer|Cushing]] and [[Curling ulcers]], [[Carcinoid tumors]], and [[carcinoid syndrome]].


==Causes==
==Causes==
===Common Causes===
'''Common Causes'''<ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref><ref name="pmid11960062">{{cite journal |vauthors=Hirschowitz BI, Lanas A |title=Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse |journal=J. Clin. Gastroenterol. |volume=34 |issue=5 |pages=523–8 |year=2002 |pmid=11960062 |doi= |url=}}</ref><ref name="pmid28150170">{{cite journal |vauthors=Dovjak P |title=[Duodenal ulcers, gastric ulcers and Helicobacter pylori] |language=German |journal=Z Gerontol Geriatr |volume=50 |issue=2 |pages=159–169 |year=2017 |pmid=28150170 |doi=10.1007/s00391-017-1190-x |url=}}</ref>
*[[Helicobacter pylori]]<ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>
*[[Helicobacter pylori]]
*[[NSAID]]s<ref name="pmid11960062">{{cite journal |vauthors=Hirschowitz BI, Lanas A |title=Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse |journal=J. Clin. Gastroenterol. |volume=34 |issue=5 |pages=523–8 |year=2002 |pmid=11960062 |doi= |url=}}</ref>
*[[NSAID]]s 
Less common causes of peptic ulcer disease
'''Less common causes'''
*Hormonal or mediator-induced including secondary acid hypersecretory states  
*[[Hormonal]] or mediator-induced including secondary acid hypersecretory states  
**[[Gastrinomas]]
**[[Gastrinomas]]
** [[Mastocytosis|Systemic mastocytosis]]
** [[Mastocytosis|Systemic mastocytosis]]
** [[Carcinoid syndrome]]
** [[Carcinoid syndrome]]
** [[Myeloproliferative disease|Myeloproliferative disorder]]   
** [[Myeloproliferative disease|Myeloproliferative disorder]]   
*Antral g - cell hyperfunction  
*Antral G-cell hyperfunction  
*Post-surgical -Antral exclusion and post gastric bypass surgery
*Post-surgical antral exclusion and post [[gastric]] bypass [[surgery]]
*Tumors-cancers and [[lymphoma]]  
*Cancers and [[lymphoma|lymphomas]]  
*Cameron [[ulcer]] (gastric ulcer where a [[hiatus hernia]] passes through the [[diaphragmatic hiatus]])
*Cameron [[ulcer]] ([[gastric]] [[ulcer]] where a [[hiatus hernia]] passes through the [[diaphragmatic hiatus]])
*True idiopathic ulcer.
*True idiopathic [[ulcer]]
'''Rare causes of peptic ulcer disease''' <ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>
'''Rare causes of peptic ulcer disease'''  
* [[Crohn's disease|Crohn’s disease]] of the stomach or duodenum
* [[Crohn's disease|Crohn’s disease]] of the [[stomach]] or [[duodenum]]
* [[Eosinophilic gastroduodenitis]]
* [[Eosinophilic gastroduodenitis]]
* Systemic mastocytosis
* Systemic [[mastocytosis]]
* Radiation damage
* [[Radiation]] damage
* Viral infections (eg [[cytomegalovirus]] or [[Herpes simplex|herpes simplex infection]], in particular in immunocompromised patients)
* [[Viral infections]] (eg [[cytomegalovirus]] or [[Herpes simplex|herpes simplex infection]], in particular in [[immunocompromised]] patients)
*Colonisation of stomach with H heilmanii
*Colonization of [[stomach]] with H heilmanii
* Severe systemic disease
* Severe [[systemic disease]]
 
'''Genetic causes'''<ref name="pmid17312377">{{cite journal| author=Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V et al.| title=Gastrinoma (duodenal and pancreatic). | journal=Neuroendocrinology | year= 2006 | volume= 84 | issue= 3 | pages= 173-82 | pmid=17312377 | doi=10.1159/000098009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17312377  }} </ref>
 
*Peptic ulcer disease caused by gastrinomas [[Zollinger-Ellison syndrome|(Zollinger-Ellison syndrome]]) caused by a [[mutation]] in MEN [[gene]] present on [[chromosome]] 11q13
'''Genetic causes''' -<ref name="pmid17312377">{{cite journal| author=Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V et al.| title=Gastrinoma (duodenal and pancreatic). | journal=Neuroendocrinology | year= 2006 | volume= 84 | issue= 3 | pages= 173-82 | pmid=17312377 | doi=10.1159/000098009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17312377  }} </ref>
*Peptic ulcer disease is caused by gastrinomas [[Zollinger-Ellison syndrome|(Zollinger-Ellison syndrome]])caused by a mutation in MEN gene present on chromosome 11q13.
 
===Causes by Organ System===
===Causes by Organ System===


{|style="width:80%; height:100px" border="1"
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| [[Rosacea]],Chronic idiopathic [[urticaria]] ,[[Psoriasis|Psoriasis vulgaris]] ,[[Behçet's disease|Behcet's disease]] ,[[Alopecia areata]],[[Sweet's syndrome]] <ref name="pmid25045884">{{cite journal| author=Kutlubay Z, Zara T, Engin B, Serdaroğlu S, Tüzün Y, Yilmaz E et al.| title=Helicobacter pylori infection and skin disorders. | journal=Hong Kong Med J | year= 2014 | volume= 20 | issue= 4 | pages= 317-24 | pmid=25045884 | doi=10.12809/hkmj134174 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25045884  }} </ref>
| bgcolor="Beige" | [[Rosacea]],Chronic idiopathic [[urticaria]] ,[[Psoriasis|Psoriasis vulgaris]] ,[[Behçet's disease|Behcet's disease]] ,[[Alopecia areata]],[[Sweet's syndrome]] <ref name="pmid25045884">{{cite journal| author=Kutlubay Z, Zara T, Engin B, Serdaroğlu S, Tüzün Y, Yilmaz E et al.| title=Helicobacter pylori infection and skin disorders. | journal=Hong Kong Med J | year= 2014 | volume= 20 | issue= 4 | pages= 317-24 | pmid=25045884 | doi=10.12809/hkmj134174 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25045884  }} </ref>
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Aceclofenac]], [[Acemetacin]], [[Alendronate]], [[Artemether and lumefantrin]], [[Aspirin]], [[Azapropazone]], [[Benoxaprofen]], [[Bisphosphonates]], [[Carbinoxamine]], [[Celecoxib]], [[Clopidogrel]], [[Dexamethasone]], [[Diclofenac]], [[Diflunisal]], [[Ethanol]], [[ethanolamine oleate]], [[Etidronic acid]], [[Etodolac]], [[Etoricoxib]], [[Febuxostat]], [[Fenbufen]], [[Fenoprofen]], [[Flurbiprofen]], [[Glucocorticoids]], [[Hydrocortisone]], [[Ibuprofen]], [[Indomethacin]], [[Ketoprofen]], [[Laxative abuse]], [[Mefenamic acid]], [[Meloxicam]], [[Mepenzolate bromide]], [[Methylprednisolone]], [[Nabumetone]], [[Naproxen]], [[Naproxen and esomeprazole magnesium]], [[Niacin]], [[Non steroidal anti-inflammatory drugs]], [[Oxcarbazepine]], [[Para-amino salicylic acid]], [[Pergolide]], [[Phenylbutazone]], [[Pramipexole]], [[Piroxicam]], [[Pramipexole]], [[Prednisolone]], [[Prednisone]], [[Rofecoxib]], [[Sertraline]], [[Sulindac]], [[Tacrolimus]], [[Tenoxicam]], [[Tiaprofenic acid]],  [[Tocilizumab]], [[Tolazoline]], [[Tolmetin]], [[Trimetrexate]]
| bgcolor="Beige" | [[Aceclofenac]], [[Acemetacin]], [[Alendronate]], [[Artemether and lumefantrin]], [[Aspirin]], [[Azapropazone]], [[Benoxaprofen]], [[Bisphosphonates]], [[Carbinoxamine]], [[Celecoxib]], [[Clopidogrel]], [[Dexamethasone]], [[Diclofenac]], [[Diflunisal]], [[Ethanol]], [[ethanolamine oleate]], [[Etidronic acid]], [[Etodolac]], [[Etoricoxib]], [[Febuxostat]], [[Fenbufen]], [[Fenoprofen]], [[Flurbiprofen]], [[Glucocorticoids]], [[Hydrocortisone]], [[Ibuprofen]], [[Indomethacin]], [[Ketoprofen]], [[Laxative abuse]], [[Mefenamic acid]], [[Meloxicam]], [[Mepenzolate bromide]], [[Methylprednisolone]], [[Nabumetone]], [[Naproxen]], [[Naproxen and esomeprazole magnesium]], [[Niacin]], [[Non steroidal anti-inflammatory drugs]], [[Oxcarbazepine]], [[Para-amino salicylic acid]], [[Pergolide]], [[Phenylbutazone]], [[Pramipexole]], [[Piroxicam]], [[Pramipexole]], [[Prednisolone]], [[Prednisone]], [[Rofecoxib]], [[Sertraline]], [[Sulindac]], [[Tacrolimus]], [[Tenoxicam]], [[Tiaprofenic acid]],  [[Tocilizumab]], [[Tolazoline]], [[Tolmetin]], [[Trimetrexate]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Cushing syndrome]], [[Multiple endocrine neoplasia type 1]], [[Zollinger-Ellison syndrome]], [[Hyperparathyroidism|primary hyperparathyroidism]]
| bgcolor="Beige" | [[Cushing syndrome]], [[Multiple endocrine neoplasia type 1]], [[Zollinger-Ellison syndrome]], [[Hyperparathyroidism|primary hyperparathyroidism]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Crohn disease]], [[Cushing ulcers]], [[Dieulafoy's lesion]], [[Duodenal ulcer]], [[Eosinophilic gastroenteritis]], [[Gastric ulcer]], [[Oesophagitis]], [[Zollinger-Ellison syndrome]], [[Carcinoid tumours and carcinoid syndrome]], [[Stomach cancer]], [[Curling ulcers]]
| bgcolor="Beige" | [[Crohn disease]], [[Cushing ulcers]], [[Dieulafoy's lesion]], [[Duodenal ulcer]], [[Eosinophilic gastroenteritis]], [[Gastric ulcer]], [[Oesophagitis]], [[Zollinger-Ellison syndrome]], [[Carcinoid tumours and carcinoid syndrome]], [[Stomach cancer]], [[Curling ulcers]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Zollinger -Ellison syndrome]] associated with [[MEN TYPE 1]] syndrome caused by mutation in MEN gene present on chromosome 11q 13  
| bgcolor="Beige" | [[Zollinger -Ellison syndrome]] associated with [[MEN TYPE 1]] syndrome caused by mutation in MEN [[gene]] present on [[chromosome]] 11q 13  
|-
|-
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Mastocytosis]], [[Polycythaemia rubra vera]], [[Primary thrombocythemia]]
| bgcolor="Beige" | [[Mastocytosis]], [[Polycythaemia rubra vera]], [[Primary thrombocythemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Mechanical ventilation]]
| bgcolor="Beige" | [[Mechanical ventilation]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Helicobacter pylori]]
| bgcolor="Beige" | [[Helicobacter pylori]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Cushing ulcers]]
| bgcolor="Beige" | [[Cushing ulcers]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Hypercalcaemia]]
| bgcolor="Beige" | [[Hypercalcaemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Carcinoid tumours and carcinoid syndrome]], [[Stomach cancer]], [[Zollinger-Ellison syndrome]]
| bgcolor="Beige" | [[Carcinoid tumours and carcinoid syndrome]], [[Stomach cancer]], [[Zollinger-Ellison syndrome|Zollinger-Ellison syndrome ,]] [[gastrinomas]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Aceclofenac]], [[Acemetacin]], [[Alendronate]], [[Aspirin]], [[Azapropazone]], [[Benoxaprofen]], [[Bisphosphonates]], [[Celecoxib]], [[Clopidogrel]], [[Diclofenac]], [[Diflunisal]], [[Ethanol]], [[Etodolac]], [[Etoricoxib]], [[Fenbufen]], [[Fenoprofen]], [[Flurbiprofen]], [[Glucocorticoids]], [[Ibuprofen]], [[Indomethacin]], [[Ketoprofen]], [[Laxative abuse]], [[Mefenamic acid]], [[Meloxicam]], [[Nabumetone]], [[Naproxen]], [[Non steroidal anti-inflammatory drugs]], [[Para-amino salicylic acid]], [[Phenylbutazone]], [[Piroxicam]], [[Prednisolone]], [[Rofecoxib]], [[Sulindac]], [[Tacrolimus]], [[Tenoxicam]], [[Tiaprofenic acid]], [[Tolazoline]], [[Trimetrexate]]
| bgcolor="Beige" | [[Aceclofenac]], [[Acemetacin]], [[Alendronate]], [[Aspirin]], [[Azapropazone]], [[Benoxaprofen]], [[Bisphosphonates]], [[Celecoxib]], [[Clopidogrel]], [[Diclofenac]], [[Diflunisal]], [[Ethanol]], [[Etodolac]], [[Etoricoxib]], [[Fenbufen]], [[Fenoprofen]], [[Flurbiprofen]], [[Glucocorticoids]], [[Ibuprofen]], [[Indomethacin]], [[Ketoprofen]], [[Laxative abuse]], [[Mefenamic acid]], [[Meloxicam]], [[Nabumetone]], [[Naproxen]], [[Non steroidal anti-inflammatory drugs]], [[Para-amino salicylic acid]], [[Phenylbutazone]], [[Piroxicam]], [[Prednisolone]], [[Rofecoxib]], [[Sulindac]], [[Tacrolimus]], [[Tenoxicam]], [[Tiaprofenic acid]], [[Tolazoline]], [[Trimetrexate]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| [[Curling ulcers]]
| bgcolor="Beige" | [[Curling ulcers]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | [[Sarcoidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | [[Hypercalcemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | [[Fibromyalgia]]<ref name="pmid28384332" />
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Burns]]
| bgcolor="Beige" | [[Burns]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Alcohol]], [[Caffeine]], [[Smoking]]
| bgcolor="Beige" | [[Alcohol]], [[Caffeine]], [[Smoking]]
|-
|-
|}
|}
Line 221: Line 218:
*[[Zollinger-Ellison syndrome]]
*[[Zollinger-Ellison syndrome]]
{{EndMultiCol}}
{{EndMultiCol}}
Common causes
*[[Helicobacter pylori|Helicobacter pylori (]]60% gastric and 50-75% duodenal ulcers <ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>)
*Drugs-[[Non-steroidal anti-inflammatory drug|NSAIDs]] including [[aspirin]]<ref name="pmid11960062">{{cite journal |vauthors=Hirschowitz BI, Lanas A |title=Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse |journal=J. Clin. Gastroenterol. |volume=34 |issue=5 |pages=523–8 |year=2002 |pmid=11960062 |doi= |url=}}</ref>
Less common causes of peptic ulcer disease
*Hormonal or mediator-induced including secondary acid hypersecretory states
**[[Gastrinomas]]
** [[Mastocytosis|Systemic mastocytosis]]
** [[Carcinoid syndrome]]
** [[Myeloproliferative disease|Myeloproliferative disorder]] 
*Antral g - cell hyperfunction
*Post-surgical -Antral exclusion and post gastric bypass surgery
*Tumors-cancers and [[lymphoma]]
*Cameron [[ulcer]] (gastric ulcer where a [[hiatus hernia]] passes through the [[diaphragmatic hiatus]])
*True idiopathic ulcer.
'''Rare causes of peptic ulcer disease''' <ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>
* [[Crohn's disease|Crohn’s disease]] of the stomach or duodenum
* [[Eosinophilic gastroduodenitis]]
* Systemic mastocytosis
* Radiation damage
* Viral infections (eg [[cytomegalovirus]] or [[Herpes simplex|herpes simplex infection]], in particular in immunocompromised patients)
*Colonisation of stomach with H heilmanii
* Severe systemic disease
'''Genetic causes''' -<ref name="pmid17312377">{{cite journal| author=Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V et al.| title=Gastrinoma (duodenal and pancreatic). | journal=Neuroendocrinology | year= 2006 | volume= 84 | issue= 3 | pages= 173-82 | pmid=17312377 | doi=10.1159/000098009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17312377  }} </ref>
*Peptic ulcer disease is caused by gastrinomas [[Zollinger-Ellison syndrome|(Zollinger-Ellison syndrome]])caused by a mutation in MEN gene present on chromosome 11q13.
===Causes by organ sys===
* For an example of the causes by organ system table in a causes microchapter, click [[Jaundice causes#Causes by Organ System|here]].
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | [[Rosacea]],Chronic idiopathic [[urticaria]] ,[[Psoriasis|Psoriasis vulgaris]] ,[[Behçet's disease|Behcet's disease]] ,[[Alopecia areata]],[[Sweet's syndrome]] <ref name="pmid25045884">{{cite journal| author=Kutlubay Z, Zara T, Engin B, Serdaroğlu S, Tüzün Y, Yilmaz E et al.| title=Helicobacter pylori infection and skin disorders. | journal=Hong Kong Med J | year= 2014 | volume= 20 | issue= 4 | pages= 317-24 | pmid=25045884 | doi=10.12809/hkmj134174 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25045884  }} </ref>
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | serotonin reuptake -[[NSAIDs]],[[Clopidogrel]],[[spironolactone]],[[sirolimus]],[[Bisphosphonate|bisphosphonates]] (when combined with NSAIDs),[[Mycophenolate sodium|mycophenolate mofetil]],[[spironolactone]] ,chemotherapy (hepatic infusion of [[5 - fluorouracil]] ,[[Selective serotonin reuptake inhibitor|selective serotonin reuptake  inhibitor]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | [[Diabetes mellitus]]
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" |smoking, excess alcohol consumption, caffeine  ,more common in patients with [[Diabetes mellitus|Diabetes Mellitus]] ,hypertension ,metabolic syndrome<ref name="pmid28834889">{{cite journal| author=Lee YB, Yu J, Choi HH, Jeon BS, Kim HK, Kim SW et al.| title=The association between peptic ulcer diseases and mental health problems: A population-based study: a STROBE compliant article. | journal=Medicine (Baltimore) | year= 2017 | volume= 96 | issue= 34 | pages= e7828 | pmid=28834889 | doi=10.1097/MD.0000000000007828 | pmc=5572011 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28834889  }} </ref>
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | [[Crohn's disease|Crohn’s disease]] of the stomach or duodenum, [[Eosinophilic gastroduodenitis]]
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" |[[Zollinger -Ellison syndrome]] associated with [[MEN TYPE 1]] syndrome caused by mutation in MEN gene present on chromosome 11q 13
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | [[Helicobacter pylori]] (60% gastric and 50-75% duodenal ulcers ), [[Herpes simplex virus type 1]], [[Cytomegalovirus]], [[Helicobacter heilmanni]]<nowiki/>i, [[Tuberculosis]], [[syphilis]], and [[mucormycosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | [[Non-beta cell tumor]] ,[[carcinoid syndrome]] , [[gastrinomas]]
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | severe [[stress]], depressed mood, suicidal ideation and psychological counseling <ref name="pmid28834889">{{cite journal| author=Lee YB, Yu J, Choi HH, Jeon BS, Kim HK, Kim SW et al.| title=The association between peptic ulcer diseases and mental health problems: A population-based study: a STROBE compliant article. | journal=Medicine (Baltimore) | year= 2017 | volume= 96 | issue= 34 | pages= e7828 | pmid=28834889 | doi=10.1097/MD.0000000000007828 | pmc=5572011 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28834889  }} </ref>
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | [[COPD]],[[Sarcoidosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | [[Hypercalcemia]]
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | [[Fibromyalgia]]<ref name="pmid28384332">Wang KA, Wang JC, Lin CL, Tseng CH (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28384332 Association between fibromyalgia syndrome and peptic ulcer disease development.] ''PLoS One'' 12 (4):e0175370. [http://dx.doi.org/10.1371/journal.pone.0175370 DOI:10.1371/journal.pone.0175370] PMID: [https://pubmed.gov/28384332 28384332]</ref>
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | [[Cushing ulcers]]
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | No underlying causes
|-
|}
Causes in alphabetical order[edit | edit source]
List the causes of the disease in alphabetical order.
Cause 1 Alopecia areata
Cause 2 Behcet's disease
Cause 3  caffeine
Cause 4
Cause 5
Cause 6
Cause 7
Cause 8
Cause 9
Cause 10


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Gastroenterology]]
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Latest revision as of 23:37, 29 July 2020

Peptic ulcer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Peptic Ulcer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Upper GI Endoscopy

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Endoscopic management
Surgical management

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

2017 ACG Guidelines for Peptic Ulcer Disease

Guidelines for the Indications to Test for, and to Treat, H. pylori Infection

Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America

Guidlines for factors that predict the successful eradication when treating H. pylori infection

Guidelines to document H. pylori antimicrobial resistance in the North America

Guidelines for evaluation and testing of H. pylori antibiotic resistance

Guidelines for when to test for treatment success after H. pylori eradication therapy

Guidelines for penicillin allergy in patients with H. pylori infection

Guidelines for the salvage therapy

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Risk calculators and risk factors for Peptic ulcer causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Common causes of peptic ulcer disease include Helicobacter pylori infection and NSAID use. Less common causes of peptic ulcer disease include Crohn's disease, Zollinger-Ellison syndrome, Cushing and Curling ulcers, Carcinoid tumors, and carcinoid syndrome.

Causes

Common Causes[1][2][3]

Less common causes

Rare causes of peptic ulcer disease

Genetic causes[4]

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic Rosacea,Chronic idiopathic urticaria ,Psoriasis vulgaris ,Behcet's disease ,Alopecia areata,Sweet's syndrome [5]
Drug Side Effect Aceclofenac, Acemetacin, Alendronate, Artemether and lumefantrin, Aspirin, Azapropazone, Benoxaprofen, Bisphosphonates, Carbinoxamine, Celecoxib, Clopidogrel, Dexamethasone, Diclofenac, Diflunisal, Ethanol, ethanolamine oleate, Etidronic acid, Etodolac, Etoricoxib, Febuxostat, Fenbufen, Fenoprofen, Flurbiprofen, Glucocorticoids, Hydrocortisone, Ibuprofen, Indomethacin, Ketoprofen, Laxative abuse, Mefenamic acid, Meloxicam, Mepenzolate bromide, Methylprednisolone, Nabumetone, Naproxen, Naproxen and esomeprazole magnesium, Niacin, Non steroidal anti-inflammatory drugs, Oxcarbazepine, Para-amino salicylic acid, Pergolide, Phenylbutazone, Pramipexole, Piroxicam, Pramipexole, Prednisolone, Prednisone, Rofecoxib, Sertraline, Sulindac, Tacrolimus, Tenoxicam, Tiaprofenic acid, Tocilizumab, Tolazoline, Tolmetin, Trimetrexate
Ear Nose Throat No underlying causes
Endocrine Cushing syndrome, Multiple endocrine neoplasia type 1, Zollinger-Ellison syndrome, primary hyperparathyroidism
Environmental No underlying causes
Gastroenterologic Crohn disease, Cushing ulcers, Dieulafoy's lesion, Duodenal ulcer, Eosinophilic gastroenteritis, Gastric ulcer, Oesophagitis, Zollinger-Ellison syndrome, Carcinoid tumours and carcinoid syndrome, Stomach cancer, Curling ulcers
Genetic Zollinger -Ellison syndrome associated with MEN TYPE 1 syndrome caused by mutation in MEN gene present on chromosome 11q 13
Hematologic Mastocytosis, Polycythaemia rubra vera, Primary thrombocythemia
Iatrogenic Mechanical ventilation
Infectious Disease Helicobacter pylori
Musculoskeletal / Ortho No underlying causes
Neurologic Cushing ulcers
Nutritional / Metabolic Hypercalcaemia
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid tumours and carcinoid syndrome, Stomach cancer, Zollinger-Ellison syndrome , gastrinomas
Opthalmologic No underlying causes
Overdose / Toxicity Aceclofenac, Acemetacin, Alendronate, Aspirin, Azapropazone, Benoxaprofen, Bisphosphonates, Celecoxib, Clopidogrel, Diclofenac, Diflunisal, Ethanol, Etodolac, Etoricoxib, Fenbufen, Fenoprofen, Flurbiprofen, Glucocorticoids, Ibuprofen, Indomethacin, Ketoprofen, Laxative abuse, Mefenamic acid, Meloxicam, Nabumetone, Naproxen, Non steroidal anti-inflammatory drugs, Para-amino salicylic acid, Phenylbutazone, Piroxicam, Prednisolone, Rofecoxib, Sulindac, Tacrolimus, Tenoxicam, Tiaprofenic acid, Tolazoline, Trimetrexate
Psychiatric Curling ulcers
Pulmonary Sarcoidosis
Renal / Electrolyte Hypercalcemia
Rheum / Immune / Allergy Fibromyalgia[6]
Sexual No underlying causes
Trauma Burns
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcohol, Caffeine, Smoking

Causes in Alphabetical Order


References

  1. ↑ Malfertheiner P, Chan FK, McColl KE (2009). "Peptic ulcer disease". Lancet. 374 (9699): 1449–61. doi:10.1016/S0140-6736(09)60938-7. PMID 19683340.
  2. ↑ Hirschowitz BI, Lanas A (2002). "Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse". J. Clin. Gastroenterol. 34 (5): 523–8. PMID 11960062.
  3. ↑ Dovjak P (2017). "[Duodenal ulcers, gastric ulcers and Helicobacter pylori]". Z Gerontol Geriatr (in German). 50 (2): 159–169. doi:10.1007/s00391-017-1190-x. PMID 28150170.
  4. ↑ Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V; et al. (2006). "Gastrinoma (duodenal and pancreatic)". Neuroendocrinology. 84 (3): 173–82. doi:10.1159/000098009. PMID 17312377.
  5. ↑ Kutlubay Z, Zara T, Engin B, Serdaroğlu S, Tüzün Y, Yilmaz E; et al. (2014). "Helicobacter pylori infection and skin disorders". Hong Kong Med J. 20 (4): 317–24. doi:10.12809/hkmj134174. PMID 25045884.
  6. ↑

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