Medicine Gastroenterology for UPSC CMS: Peptic Ulcer, IBD, Liver Disease and Pancreatitis

Peptic Ulcer Disease#

H. pylori (70%), NSAIDs (20%). Complications: bleeding (hematemesis, melena), perforation (rigid abdomen, free air), obstruction (pyloric stenosis).

Treatment: PPI + dual antibiotics (amoxicillin + clarithromycin or metronidazole) for 14 days.

IBD#

Ulcerative colitis: Continuous from rectum. Pseudopolyps. Toxic megacolon. Treatment: 5-ASA, steroids, azathioprine, biologics.

Crohn: Skip lesions. Transmural. Fistulas, strictures. Any GI tract. Perianal disease.

Acute Pancreatitis#

Causes: Gallstones (40%), Alcohol (30%). Scoring: APACHE II, BISAP, Ranson. CT severity index.