Question 100

Question:

A 48-year-old woman from Guatemala complains of epigastric pain. Which of the following clinical settings is most consistent with a duodenal ulcer?

Correct Answer: D.  H. pylori infection

H. pylori is implicated in almost all cases of duodenal ulcers. Its incidence is very high in developing countries. Chronic NSAID use and increased pain after meals are associated with gastric ulcers. Crohn’s disease has no association with peptic ulcer disease. Gastric carcinoma is considerably less likely to result in ulceration. Pernicious anemia, autoimmune destruction of the gastric parietal cells, results in atrophic gastritis and would lead to decreased acid secretion.