We commonly use the terms Stress ulcer (Stress-Related Mucosal Disease = SRMD) and Peptic ulcer disease (PUD) interchangeably in the ICU while talking about "GI prophylaxis." But both are different conditions. Probably, what we are worried about in our "unit" patients is mostly SRMD.
SRMD is multiple superficial erosions occurring in the proximal gastric bulb involving superficial capillaries secondary to mucosal hypoperfusion, and perforations are rare.
PUD is a few deep erosions usually occurring in the duodenum involving one vessel secondary to other reasons (drugs, H.Pylori, hypersecretory states, etc.), and perforation is common.
#GI
References:
1. Bardou M, Quenot JP, Barkun A. Stress-related mucosal disease in the critically ill patient. Nat Rev Gastroenterol Hepatol. 2015 Feb;12(2):98-107. doi: 10.1038/nrgastro.2014.235. Epub 2015 Jan 6. PMID: 25560847.
2. Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017 Aug 5;390(10094):613-624. doi: 10.1016/S0140-6736(16)32404-7. Epub 2017 Feb 25. PMID: 28242110.
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