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Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer, is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus.[1][2] An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as aduodenal ulcer. The most common symptoms are waking at night withupper abdominal pain or upper abdominal pain that improves with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms.[1] Complications may include bleeding,perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of people.[3]
<!-- 定義與症狀 -->
’’’消化性潰瘍’’’（{{lang-en|peptic ulcer disease}}、{{lang-en|peptic ulcer}}，簡稱PUD），又稱’’’胃潰瘍’’’（{{lang-en|stomach ulcer}}。這是指[[胃]]或[[小腸]]前段，有時也包含了[[食道下端]]的黏膜損傷[1][2]。在胃發生的潰瘍稱作’’’胃潰瘍’’’，在小腸的開頭部分所發生的潰瘍則是’’’十二指腸潰瘍’’’。最常見的症狀是晚上因上腹部疼痛而醒來，或此疼痛因進食而緩解。胃潰瘍的疼痛大多被用「燒灼感」或「悶痛」描述，其他常見的症狀還包括打嗝、嘔吐、不明原因的體重減輕、或是胃口不佳，但年紀較大的患者中約有三分之一完全沒有症狀[1]。胃潰瘍若不處理，可能會演變成出血、穿孔、或是胃出口阻塞，出血的發生率約為15%。
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Common causes include the bacteria, Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs).[1] Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease,Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others.[1][4] Older people are more sensitive to the ulcer causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow. H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder.[1]
<!-- 病因與診斷 -->
常見的致病因子包括[[幽門螺旋桿菌]]以及[[非固醇類抗發炎藥]]。其他較少見的致病因子包括[[抽煙]]、嚴重疾病造成的壓力、[[貝賽特氏症]]、[[胃泌素瘤]]、[[克隆氏症]]以及[[肝硬化]]。高齡者服用非固醇類抗發炎藥更容易造成潰瘍。當臨床症狀出現時，可以進行[[內視鏡]]以及[[鋇劑吞嚥檢查法]]進行檢查。臨床上可以抽血檢測是否有幽門螺旋桿菌的抗體、進行尿素呼氣試驗、進行糞便檢查或進行胃活組織檢查來診斷是否有幽門螺旋桿菌的感染。造成類似症狀的其他病症包括胃癌、冠狀動脈心臟疾病、胃粘膜發炎以及膽囊發炎。
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Diet does not play an important role in either causing or preventing ulcers.[5] Treatment includes stopping smoking, stopping NSAIDs, stopping alcohol, and medications to decrease stomach acid. The medication used to decrease acid is usually either a proton pump inhibitor (PPI) or an H2 blocker with four weeks of treatment initially recommended.[1] Ulcers due to H. pylori are treated with a combination of medications such as amoxicillin,clarithromycin, and a PPI. Antibiotic resistance is increasing and thus treatment may not always be effective.[6]Bleeding ulcers may be treated by endoscopy, with open surgery typically only used in cases in which it is not successful.[3]
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對引起或預防潰瘍的層面而言，飲食內容並非重要的影響因子。
較常見的治療方式包含：戒菸、戒酒、停用[[非類固醇消炎止痛藥]]（{{lang-en|Nonsteroidal anti-inflammatory drug，簡稱NSAIDs}}），以及使用抑制胃酸的藥物。
常見的治療藥物像是[[氫離子幫浦阻斷劑]]（{{lang-en|Proton-pump inhibitor，簡稱PPI}}）或[[H2受體阻抗劑]]（{{lang-en|H2 antagonist}}，俗稱{{lang-en|H2 blocker}}），通常建議的基本用藥療期為四週。
[[幽門螺旋桿菌]]造成的潰瘍，通常會以[[安默西林]]（{{lang-en|Amoxicillin}}）、（{{le|Clarithromycin中文翻譯藥物名|Clarithromycin}}）與[[氫離子幫浦阻斷劑]]作為藥物組合治療；但因[[抗生素抗藥性]]與日俱增，此療法並非絕對有效。
出血性潰瘍有時會以[[內視鏡]]進行治療，而外科手術只會在內視鏡治療無法處理時進行。
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Peptic ulcers are present in around 4% of the population.[1] About 10% of people develop a peptic ulcer at some point in their life.[7] They resulted in 301,000 deaths in 2013 down from 327,000 deaths in 1990.[8] The first description of a perforated peptic ulcer was in 1670 in Princess Henrietta of England.[3] H. pylori was first discovered in 1981 by Barry Marshall and Robin Warren.[6]
<!-- 流行病學與歷史-->
在所有人口中，胃潰瘍的盛行率大約為4%。大約有10%的人會在一生中產生胃潰瘍。胃潰瘍從1990年造成 327,000人死亡降低至2013年造成301,000人死亡。胃潰瘍穿孔在1670年第一次在{{le|英國的亨麗埃塔公主|Henrietta of England}}身上被敘述。幽門桿菌是在1981年由[[巴里·馬歇爾]]以及[[罗宾·沃伦]]發現。
20151204 尚未整合至中文