PEPTIC ULCER DISEASE

LEARNING OBJECTIVES:

KNOWLEDGE – Students should know and appreciate the following:

1. Peptic ulcer disease is a common condition affecting 4-5 million Americans at any given time.
2. Peptic ulcer disease tends to run a chronic course with remissions and exacerbations over many years unless H. pylori is eradicated.
3. H. pylori is the causative agents in most cases of peptic ulcer disease, NSAID are an important factor, particularly in the elderly.
4. Differences between duodenal ulcer and gastric ulcer presentation.
5. Diagnostic approach to patients with suspected peptic ulcer disease.
6. Treatment of peptic ulcer disease, including therapy for the eradication of Helicobacter pylori.
7. Complications (GI bleeding, perforation, obstruction) of peptic ulcer disease and indications for surgical intervention.

SKILLS – Students should be able to:

1. Obtain, document and present an appropriate and accurate medical history in patients with suspected peptic ulcer disease.
2. Perform an accurate physical exam, including rectal exam to check for occult GI bleeding.
3. Order appropriate laboratory and diagnostic studies in patients with suspected peptic ulcer disease.
4. Plan appropriate treatment program, including the treatment of Helicobacter pylori.

ATTITUDES AND PROFESSIONAL BEHAVIORS:

• Students should recognize the impact of peptic ulcer disease on patients, and the need for aggressive management in all patients, primarily the eradication of H. pylori if present.

RECOMMENDED READINGS:

1. Yamada, Tadataka.   Handbook of Gastroenterology . 2000, Chap 31 (The Medicine Education Office, 7604, has a copy of this reference.)