Peptic Ulcer Disease (PUD)

Known Symptoms

Common symptoms:
- Epigastric burning or gnawing pain (may improve or worsen with food: gastric ulcers often worsen, duodenal ulcers may improve).
- Bloating, nausea, and early satiety.
Atypical presentations: Asymptomatic (especially in NSAID users).
Red-flag symptoms/complications:
- Hematemesis, melena, or hematochezia (indicating bleeding).
- Severe, penetrating pain radiating to the back (suggesting penetration/perforation).
- Unintended weight loss, vomiting (suggesting obstruction or malignancy).

Known Causes

Haemorrhage: Most common complication.
Perforation: Surgical emergency.
Gastric outlet obstruction: Due to scarring and oedema.
Penetration: Into adjacent organs (e.g., pancreas).
Malignant transformation: Rare, but gastric ulcers require biopsy to rule out malignancy.

Care

Prevention:
- H. pylori screening/treatment in high-risk groups.
- Avoid unnecessary NSAIDs; use the lowest effective dose with PPI cover if needed.
- Smoking cessation, moderation of alcohol.
Follow-up:
- Confirm H. pylori eradication (e.g., urea breath test).
- Repeat endoscopy in 6-8 weeks for gastric ulcers to confirm healing and exclude malignancy.
- Long-term PPI use only if indicated (e.g., recurrent ulcers, continued NSAID use).

Known Symptoms

Common symptoms:
- Epigastric burning or gnawing pain (may improve or worsen with food: gastric ulcers often worsen, duodenal ulcers may improve).
- Bloating, nausea, and early satiety.
Atypical presentations: Asymptomatic (especially in NSAID users).
Red-flag symptoms/complications:
- Hematemesis, melena, or hematochezia (indicating bleeding).
- Severe, penetrating pain radiating to the back (suggesting penetration/perforation).
- Unintended weight loss, vomiting (suggesting obstruction or malignancy).

Known Causes

Care

Prevention:
- H. pylori screening/treatment in high-risk groups.
- Avoid unnecessary NSAIDs; use the lowest effective dose with PPI cover if needed.
- Smoking cessation, moderation of alcohol.
Follow-up:
- Confirm H. pylori eradication (e.g., urea breath test).
- Repeat endoscopy in 6-8 weeks for gastric ulcers to confirm healing and exclude malignancy.
- Long-term PPI use only if indicated (e.g., recurrent ulcers, continued NSAID use).

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Gastroenterology

Gastroenterology

Our Gastrosciences service diagnoses and treats conditions of the digestive system such as the oesophagus, stomach, small intestine, colon, liver, pancreas and bile ducts. Our team of gastroenterologists, hepatologists and specialist nurses use advanced, minimally invasive techniques to give precise care. POEM (Peroral Endoscopic Myotomy) treats oesophageal motility disorders, ESD to remove early tumours without open surgery, ERCP and SpyGlass for bile-duct problems, EndoVAC for closing leaks, STER for subepithelial tumours, and capsule endoscopy to image the small intestine. We also perform diagnostics and therapeutic endoscopy (OGD, colonoscopy, EUS, manometry, pH studies) and offer stenting, polypectomy, dilation, variceal therapy and biliary drainage as needed. In addition, age appropriate diagnostics and transplant-linked care are provided with dietitians and psychological support built into long-term plans.

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