Peptic Ulcer Disease (PUD) Concept Map: An Overview

Peptic ulcer is a disruption of mucosal integrity of the stomach and/or duodenum that can be >5 mm in size. This map links all aspects of peptic ulcer disease, including disease’s definition, types of peptic ulcer, complications, risk factors, etiology, clinical presentation, diagnosis, treatment, patient education, and follow-up. The map focuses on the link between peptic ulcer causes, diagnosis, and treatment. Whenever the cause of peptic ulcer is known through the diagnostic approach, the treatment can be determined. This means that treatment of peptic ulcer differs according to the cause of ulcer, i.e. treatment of peptic ulcer caused by helicobacter pylori infection differs from that caused by non-steroidal anti-inflammatory drugs (NSAIDs) which in turn differs from the treatment of stress-induced ulcer and Zollinger-Ellison syndrome.

Types of Peptic Ulcer

Ulcer site determines its type; gastric ulcer occurs in the lining of the stomach, duodenal ulcer occurs in the duodenum, and esophageal ulcer affects the lining of the esophagus.

Clinical Presentation

Peptic ulcer signs and symptoms can differ from patient to patient. Moreover, the ulcer may not cause any symptoms or it may just cause abdominal discomfort.  Peptic ulcer symptoms include epigastric pain, heartburn, dyspepsia, nausea, vomiting, and melena. Complications of Peptic UlcerSerious complications may occur for patients who do not seek appropriate treatment. The most common problems include:

  • bleeding ulcer (known by the presence of melena),
  • perforation of stomach or duodenum (causes epigastric pain that radiates to the back), and / or
  • gastric outlet obstruction, (causes dyspepsia and vomiting).

Etiology / Causes of Peptic Ulcer

Peptic ulcer disease occurs when aggressive factors (including gastric acid and pepsin) overwhelm defensive factors (including gastric mucus, bicarbonate, microcirculation, prostaglandins, mucosal barrier) that are involved in mucosal protection.  This damage is caused mainly by 4 causes: helicobacter pylori infection, use of non-steroidal anti-inflammatory drugs (NSAIDs), severe physiological stress, or hypersecretory states as Zollinger-Ellison syndrome. The map explains how each of the previously mentioned causes leads to ulcers. And here is a diagram showing how non-steroidal anti-inflammatory drugs’ mechanism of action leads to ulcer formation by affecting the mucus barrier of the stomach and allowing acid to cause an ulcer.

Peptic Ulcer Risk Factors

Include factors that aggravate ulcer formation and/or delay its cure. These factors are mentioned in the following part of the map.

Diagnosis of Peptic Ulcer

It is important to diagnose the underlying cause of ulcer disease properly before starting treatment, as treatment varies for different types of ulcers. The map contains more details about the diagnostic approach including:

  • Radiography.
  • Endoscopy.
  • Detection of helicobacter pylori infection.
  • Screening for Zollinger-Ellison syndrome.

Peptic Ulcer Treatment

It is determined according to the cause of the ulcer. Thus, 4 treatment protocols are stated in the map including:

  • Treatment of peptic ulcer caused by helicobacter pylori infection,
  • Treatment of NSAID-induced ulcer,
  • Treatment of stress-induced ulcer, and
  • Treatment of Zollinger-Ellison syndrome

Follow up of peptic ulcer 

Follow-up is to be conducted through the same diagnostic tests and/or procedure and depending upon ulcer type.  Details are stated in the map.

3 reasons why this is ideal for studying peptic ulcer:

  1. It displays peptic ulcer disease in a logical way; linking between ulcer causes, diagnosis, and treatment.
  2. Contains an easy-to-study peptic ulcer treatment protocols. These protocols are displayed in an organized way using comparison tables and funny cliparts that help in memorization.
  3. It makes “one unique picture” of peptic ulcer disease available in your mind for an easy recall of information during practice.

Order the map

You can order the Peptic Ulcer Disease concept map in any of the following forms according to your preference. Our maps are comprehensive in a way that can benefit both students and clinicians.

This map is available in two forms;
1. Printable version.
2. Whole map version.

Check them out below to know the difference, so that you can choose what is suitable for you. And please feel free to leave your feedback, comments, or questions in the comments section below.

PUD Concept Map, version 2.0 by Maha Atef, B PharmLast updated on: 10 July 2012

References 
DiPiro, Joseph T. Pharmacotherapy: A Pathophysiologic Approach. 6th. The McGraw-Hill Companies, 2005.Enaganti, Santosh. “Peptic ulcer disease – the disease and non-drug treatment.” Hospital Pharmacist 13. (2006): 239-43. Web. 8 Jan 2010. Fauci, Anthony S., et al. Harrison’s Online. 17th Edition ed. The McGraw-Hill Companies, 2008. Merck Medicus. 2008. 17 Feb. 2009 <http://www.merckmedicus.com /pp/us/hcp/frame_textbooks.jsp?pg=http://www.accessmedicine.com/resourceTOC.aspx? resourceID=4> Goroll, Allan H., and Albert G. Mullay. Primary Care Medicine: Office Evaluation and Management of the Adult Patient. 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2009. 537-48. Print. Le, Tri H., and George T. Fantry. “Peptic Ulcer Disease.” eMedicine. 17 Jul 2008. Medscape, Web. 8 Jan 2010. <http://emedicine.medscape.com>. “Peptic ulcer.” General Practice Notebook. Oxbridge Solutions Ltd�, Web. 8 Jan 2010. <http://www.gpnotebook.co.uk>.

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