- 🔬Pathophysiology
- Mucosal defect from H. pylori or NSAIDs disrupting the protective barrier → acid injury.
- 🩺Signs & Symptoms
- Epigastric pain — gastric ulcer 15–30 min after a meal, duodenal 2–3 h after a meal (classically eased by food); ± bleeding.
- 🎯Gold Standard Diagnosis
- EGD with biopsy; test for H. pylori (urea breath test or stool antigen).
- 💊First-line Treatment
- Stop NSAIDs; eradicate H. pylori — bismuth quadruple therapy for 14 days is preferred empirically.
High-Yield PearlTiming tells them apart: gastric ulcer pain 15–30 min after eating; duodenal 2–3 h after a meal, classically relieved by food.