Peptic ulcer disease (PUD) can affect the stomach (gastric ulcer) or duodenum (duodenal ulcer).
It is believed that Helicobacter pylori is the causative pathogen, and that PUD can be exacerbated by cigarette smoking and NSAID use.
The incidence of PUD among individuals with kidney disease and a history of chronic alcohol abuse is increased.
10%-20% of individuals with PUD may develop life-threatening complications such as hemorrhage, perforation, or obstruction.
A less-frequent stomach disorder is inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease .
Symptoms of gastric ulcers have been described as epigastric pain radiating to the back that is aggravated by food.
Epigastric pain associated with duodenal ulcers are described as a burning sensation accompanied by nausea and vomiting. The symptoms typically start when the stomach is empty and are alleviated by ingestion of antacids, milk, or food.
Peptic ulcers are managed with antibiotics to eliminate the causative bacteria, antacids to buffer gastric acid, mucosal protective agents, anticholinergic agents to decrease gastric acid production, and H2-receptor blockers and omeprazole to reduce acid secretion.
Oral manifestations associated with PUD are not common, but oral dryness due to medications may be present.
If the patient experiences persistent regurgitation of gastric acid, palatal enamel erosion may be observed.
Oral manifestations of food allergies may be encountered as major aphthous stomatitis with elevated borders.
Peutz-Jeghers Syndrome is an autosomal dominant inherited disorder characterized by intestinal hamartomatous polyps in association with mucocutaneous melanocytic macules.
- Oral Health Care Considerations
- Kavitt RT, et al. Diagnosis and treatment of peptic ulcer disease. Am J Med. 2019 Apr;132(4):447-456
- Lana A, et al. Peptic Ulcer Disease. Lancet. 2017;390(10094):613-624.
- Reshetnyak VI, et al. Helicobacter pylori: Commensal, symbiont or pathogen? World J Gastroenterol. 2021;27(7):545-560.
- Sverdén E, et al. Peptic Ulcer disease. BMJ. 2019;367:l5495.