Editing Peptic ulcer disease (section)

== '''Aetiology''' - MINT ==

* Medications
** NSAIDs/aspirin
*** Increased COX-1 inhibition       leads to decreased prostaglandins and therefore impaired mucosal       protection
*** Normally, prostaglandins       protects gastric and duodenal mucosa from luminal acid and pepsin via       increased mucin and bicarbonate secretion and increased mucosal       endothelium blood flow and promoting epithelial cell proliferation and       migration to the luminal surface
*** Risk for mucosal injury is       roughly proportionate to the anti-inflammatory effect associated with       each NSAID
*** Ulcers are more often found       in the stomach (anywhere in stomach)
*** Not typically associated       with gastritis
*** Ulcers do not usually recur       when NSAIDs are discontinued
** Steroids
* Infections
** H . Pylori
*** Separate topic
** Syphilis
** CMV - multiple round,      erythematous, raised lesions in body and antrum, often with 'halo'      pattern
* Neoplasms
** Neoplastic - ZES
*** Separate topic
** Malignancy
*** Extremely rare with       duodenal ulcers, but consider for gastric ulcers (either gastric       adenocarcinoma or metastatic melanoma/breast/lung cancer)
* Trauma
** Smoking
** Physiological stress
** Cocaine/methamphetamine
*** Causes ischaemia
* Prior gastric surgery