PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a common cause of peptic ulcer disease?

1. Excessive alcohol consumption

2. H. pylori infection

3. Stress and anxiety

4. Smoking tobacco

The correct answer is: H. pylori infection

H. pylori infection is recognized as a primary causative agent of peptic ulcer disease. Helicobacter pylori is a gram-negative bacterium that colonizes the gastric epithelium and leads to chronic inflammation of the stomach lining (chronic gastritis). This persistent inflammation can disrupt the mucosal barrier, making the stomach more susceptible to the damaging effects of gastric acid and contributing to the formation of ulcers in both the stomach and the duodenum. The pathophysiology involves the ability of H. pylori to survive in the acidic environment of the stomach and produce enzymes such as urease, which neutralize stomach acid. This, along with factors like increased gastric acid secretion, compromised mucosal defenses, and other contributing factors, leads to the development of ulcers. While excessive alcohol consumption, stress and anxiety, and smoking tobacco can each have a role in gastrointestinal health and may exacerbate ulcer symptoms or complicate existing ulcers, H. pylori remains the most significant direct cause associated with the formation of peptic ulcers. Therefore, addressing H. pylori infection is a crucial component of ulcer management and treatment strategies.