TEST QUESTION: Epigastric Pain

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TODAY’S TEST QUESTION:

CORRECT ANSWER

B) Duodenal ulcer pain is often relieved temporarily after eating a meal. BUT the pain usually returns 2-3 hours later.


MORE INFO:

  • Most ulcers are caused from either from H. pylori infections or NSAIDs.

  • There are gastric ulcers & duodenal ulcers.

  • Gastric ulcers are a little different than duodenal ulcers, as the gastric ulcers don’t quite follow a consistent pattern of pain.

  • Sometimes food can actually make gastric ulcers feel worse.

  • Duodenal ulcers tend to cause more consistent pain and are usually relieved with food.

  • Pain however, usually returns 2-3 hours after eating.

  • These patients have a tendency to wake during the night due to the pain.


OTHER ANSWERS:

  • IBS certain foods flare it and cause the pain.

  • Gastroenteritis patients will often have nausea, vomiting, fever, and diarrhea.

    • They also usually have poor PO (food/drink) intake because food may actually flare their symptoms.

    • PUD is not usually associated with diarrhea or fever.

    • Although an individual who has PUD and associated diarrhea, may have Zollinger-Ellison Syndrome; a gastrin producing tumor which causes the stomach to produce too much acid.

  • GERD can definitely cause similar epigastric burning pain.

    • Certain specific foods/drinks can worsen/exacerbate symptoms- chocolate, peppermint, garlic, alcohol, spicy foods, greasy foods.

    • These patients may have cough & a hoarse voice.

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REFERENCE:

  1. Merck Manual Professional Version https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/peptic-ulcer-disease
  2. Medscape Distinguishing GERD from PUD  https://www.medscape.com/viewarticle/460308
  3. Epocrates- PUD
DISCLAIMER: The information posted is not intended to be medical advice. This is for educational purposes. This information is intended for medical professionals & students. Check with your primary care provider if you have any questions regarding your health. This is not intended to guide in medical decisions or treatment in any way. As always, medical professionals should call the on call provider if any clarifications are needed. This is not intended to guide or direct medical decisions, treatment choices, and or interventions. State and hospital protocols should always be followed accordingly. Med Made Ez (MME) disclaims any liability for the decisions you make based on this information.

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