Which of the following is the most common cause of peptic ulcer disease?

NHM UP Staff Nurse-2023 Shift-2nd

Medical & Surgical Nursing

Easy

Appeared in: NHM UP Staff Nurse-2023 Shift-2nd

Explanation

H. pylori infection is the leading cause of peptic ulcer disease (PUD), responsible for the vast majority of both duodenal and gastric ulcers.
This gram-negative bacterium colonizes the gastric mucosa and is uniquely adapted to survive in the acidic stomach environment.
It produces the enzyme urease, which neutralizes stomach acid locally. The infection and the resulting inflammation damage the protective mucosal lining, leading to ulcer formation.
Along with the chronic use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), H. pylori infection accounts for most cases of PUD.

Option A: While radiation to the abdomen can cause mucosal injury (radiation gastritis/enteritis), it is not a primary or frequent cause of the chronic condition known as peptic ulcer disease.
Option B: Zollinger-Ellison syndrome is a rare endocrine disorder caused by gastrin-secreting tumors. It accounts for a very small fraction (less than 1%) of PUD cases.
Option C: Crohn disease is an inflammatory bowel disease (IBD). While it can cause inflammation and ulceration anywhere in the GI tract, including the stomach and duodenum, it is an uncommon cause of peptic ulcers compared to H. pylori.

Clinical Relevance

Nursing practice connection: Knowing Etiology of Peptic Ulcer Disease (PUD) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Identifying the cause of PUD is critical for effective treatment. If H. pylori is the cause, the standard of care involves eradication therapy using a combination of antibiotics and a proton pump inhibitor (PPI).
Patient education on completing the full course of antibiotics is vital to ensure successful eradication, prevent antibiotic resistance, and reduce the risk of ulcer recurrence and complications like bleeding or perforation.
What if a patient with PUD tests negative for H. pylori? The nurse should then assess for the second most common cause: chronic use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen or aspirin.

How to Approach the Question

First, identify the key phrase in the question: "most common cause."
This directs you to evaluate the options based on their prevalence as a cause of peptic ulcer disease (PUD), not just whether they can cause it.
Recall the two primary etiologies of PUD: H. pylori infection and chronic NSAID use.
Scan the options to see if either of these primary causes is listed. H. pylori infection is present.
Consider the other options. Recognize that Zollinger-Ellison syndrome, Crohn disease, and radiation are all possible but much rarer causes of ulcers.
Select H. pylori infection as it is the most frequent cause among the choices provided.

Concept Tested & Keywords

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