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A century ago, Lord Moynihan suggested that the underlying cause of dyspepsia could be discerned by symptoms alone. Subsequent studies have suggested that, unfortunately, this is not the case since the symptoms associated with upper gastrointestinal (GI) disease lack both sensitivity and specificity. ‘Classic’ symptoms of reflux disease (such as heartburn and regurgitation), peptic ulcer disease (such...
Acute gastrointestinal bleeding is an important medical emergency. Outcome and treatment are dependent upon the presence or absence of liver disease. The most important non-variceal cause is peptic ulcer. Prognosis is dependent upon the severity of bleeding, endoscopic findings and the presence of medical comorbidity. Endoscopy is undertaken only after resuscitation is optimized and is done to achieve...
Nearly all peptic ulcers are caused by either Helicobacter pylori infection or non-steroidal inflammatory drug (NSAID) use, including aspirin. As H. pylori infection is becoming less prevalent in developed countries, NSAIDs are an increasingly important cause of ulceration, particularly ulcers complicated by bleeding. Only about 15% of H. pylori-infected people develop an ulcer in their lifetime;...
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