List the 2 common causes of PUD.
The two major contributing factors to the development of PUD are gastrointestinal infection with H. pylori and nonsteroidal anti-inflammatory drug (NSAID) use. Both factors contribute to the development of PUD and interact with other risk factors to promote ulcer formation.
Helicobacter pylori infection
Associated with 40–70% of duodenal ulcers and 25–50% of gastric ulcers
The rate of H. pylori infection (and, therefore, the development of PUD) is decreasing.
Chronic NSAID use
Associated with a fourfold risk of developing PUD
Increases the risk for complications of PUD
List associated risk factors.
H. pylori infection or NSAID use alone do not typically cause ulcer formation. There are often additional risk factors present, such as the following, that increase the probability of developing an ulcer:
Shared risk factors for PUD, GERD and gastritis (i.e., smoking, heavy alcohol use, glucocorticoids, caffeine)
Psychological factors (e.g., anxiety, stress, PTSD)
List rare causes of PUD.
Acid hypersecretory states
Zollinger-Ellison syndrome (gastrinoma)
Chemotherapeutics (e.g., 5-FU)
Illicit drug use (e.g., cocaine, methamphetamine)
Systemic inflammatory diseases (e.g., Crohn disease, sarcoidosis)
Mechanical (e.g., foreign body, GI tract obstruction, postsurgical anatomy)