Sunday, April 16, 2017

Difference between Duodenal and Gastric Ulcer

Hello everyone, let’s talk about the ever confusing difference between Duodenal and Gastric Ulcer. Both the ulcers are a type of Peptic Ulcer which occurs due the action of acid resulting in the damage of alimentary mucosa. The main cause for both of them could be infection with H. pylori or intake of NSAIDs.
Duodenal Ulcer      
1. More common
2.Stress ulcer (occurs in 25-50 age group)
3. Occurs at the first inch of first part of duodenum
4. Caused due to hyperacidity and increase in the number of parietal cells
5. Hunger pain occurs (Remember it as HD- hunger pain in duodenal ulcer), pain may occur at night too (as the stomach is empty and produces more acid) 
6. Pain relieved by eating, patient has normal appetite and gains weight, no vomiting
7. Melaena may occur
8.  No chances of malignancy
9.  Tenderness in right hypochondrium
10. On barium meal study- Deformed duodenal cap, Trifoliate deformity
11. Surgery- Highly selective Vagotomy, Total truncal abdominal vagotomy

Gastric Ulcer
1. Less common
2. Occurs later in life (>60), in lower socio economic status
3. Occurs at lesser curvature of the stomach
4. Caused due to loss of the mucosal barrier, patient is hypoacidic or normoacidic and there is no increase in the number of parietal cells
5. Pain occurs after intake of food (acid production increases), no night pain
6. Pain is relieved by vomiting, loss of appetite and weight
7. Haematemesis may occur
8. 2% chances of malignancy
9. Tenderness in epigastrium
10.On barium meal study- hour glass stomach, detect gastric outlet obstruction
11.Surgery- Billroth I partial gastrectomy, Billroth II partial gastrectomy

Mnemonic by IkaN:
Pain in Duodenal ulcer Decreases on eating. Pain in Gastric ulcer is Greater on eating.

Hope this helps you guys remembering!

Ashita Kohli

11 comments:

  1. My confusion got cleared Dr.Kohli . Thank you
    Great piece of work , Really love the way u presented... God bless you ! Hoping more from you

    ReplyDelete
  2. Thank you so much. Glad you liked it so much. Hope I could help :)

    ReplyDelete
  3. Really, presented really well, awesome

    ReplyDelete
  4. Soo helpfull..u made some stuff clear in a easy way..thank u soo much

    ReplyDelete
  5. Soo helpfull..u made some stuff clear in a easy way..thank u soo much

    ReplyDelete
  6. pain one at the end is really a lifesaver!! thanks nakeya ma'am for clearing the universal confusion!!:D

    ReplyDelete

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