Symptomatic (secondary) gastroduodenal ulcers in clinical practice
Kostyukevich O.I.¹, Karnuta G.G.<sup>2

1</sup> Pirogov Russian National Research Medical University, Moscow
² Road Clinical Hospital named after N.A. Semashko, Lublino station, JSC "Russian Railways"

Prevalence of secondary, symptomatic gastroduodenal ulcers (SGU) is increasing every year. The paper presents detailed classification of SGU (stress, endocrine and drug ulcers, in patients with severe somatic diseases), differential diagnosis of primary and SGU, diagnostic algorithm and basic methods of SGU diagnosis.
One of the most frequent SGU are drug ulsers, associated mainly with NSAIDs intake. Factors and risk degree of NSAID-gastropathy development are discussed, presented in Guidelenies of American Gastroenterological Association.
The paper addresses features of the course, pathogenesis and diagnosis of hypoxic ulcers in patients with decompensated heart failure, ulcers in patients with chronic lung disease, hyperparathyroidism, Zollinger-Ellison syndrome, acute stress ulcers.
Symptomatic ulcer treatment is described in accordance with the cause. In addition to treating the underlying disease antiulcer therapy is recommended, which includes proton pump inhibitors (PPIs) - drugs, having the best efficacy and safety profile. The risk of major bleeding and death determines mandatory prophylaxis in patients at high risk of erosive and ulcerative lesions of gastrointestinal tract.

Key words: symptomatic gastroduodenal ulcers, NSAID-gastropathy, acute stress ulcers, Zollinger-Ellison syndrome.

For citation: Kostyukevich O.I., Karnuta G.G. Symptomatic (secondary) gastroduodenal ulcers in clinical practice // RMJ. 2016. № 17. P. 1153–1157.