Surgical treatment of chronic constipation: who should be referred for surgery?
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Acid-peptic disease: a comprehensive and contemporary clinical perspective
The launch of the first volume of Clínicas de Gastroenterología de México in 2025 was received with great enthusiasm by the national gastroenterology community. Its acceptance, particularly among the members of the Mexican Association of Gastroenterology, confirmed the value of having a publication that integrated, in a structured, rigorous, and up-to-date manner, the most important […]
Epidemiology and contemporary risk factors of peptic acid disease
Introduction Acid-peptic disease (APD) refers to a group of conditions that originate from an imbalance between aggressive factors (such as gastric acid, pepsin, Helicobacter pylori infection, and harmful drugs) and the defense mechanisms of the gastroduodenal mucosa,1,2 which leads to structural damage of the mucosa and submucosa of the esophagus, stomach, and duodenum, possibly with […]
Current pathophysiology of peptic ulcer disease: balance, aggression and defense
Introduction Peptic ulcer disease (PUD) represents one of the classic models in gastroenterology for studying the interaction between luminal aggressive factors and the protective mechanisms of the gastrointestinal mucosa.1,2 Throughout much of the 20th century, its pathophysiology was primarily explained based on the concept of acid hypersecretion, which led to considering hydrochloric acid as the […]
Erosive gastritis and duodenitis: causes, diagnosis and treatment
Introduction Gastritis is defined by the histological presence of inflammation in the gastric mucosa produced by infectious agents or autoimmune causes, as well as the patient’s response to these lesions. It should be mentioned that epithelial injury in the mucosa (with or without regeneration) without inflammation (host response) is termed “gastropathy”; however, these two phenomena […]
NSAID-associated ulcers: prevention and management in the personalized-medicine era
History and mechanism of action of NSAIDs Salicylates have been used as medications since the time of ancient Egypt.1 Salicylic acid was chemically synthesized in Germany in 1860, and later Felix Hoffman created acetylsalicylic acid (ASA), known as aspirin, in an attempt to improve his father’s joint symptoms without causing so many gastrointestinal (GI) effects1–3. […]
Stress ulcers and ulcer peptic disease in critically ill patients
Introduction Upper gastrointestinal bleeding secondary to stress ulcers and peptic ulcer disease (PUD) continues to be one of the most important complications in critically ill patients hospitalized in intensive care units (ICUs). In the first decades of modern critical care medicine development, this event was associated with high morbidity and mortality, prolonged hospital stays and […]
Contemporary diagnosis: endoscopy and imaging in peptic ulcer disease
Introduction Upper gastrointestinal endoscopy is considered the reference method for the diagnosis of peptic ulcer disease. Endoscopy, in addition to directly visualizing ulcers, allows biopsies to be taken and complications to be treated.1,2 Taking biopsies is essential to rule out ulcers of malignant etiology in the stomach. Gastric biopsies are also part of the protocol […]
Management of peptic ulcer bleeding: updated algorithms
Introduction Bleeding is the most frequent complication of peptic ulcer (PU), and this in turn represents the main cause of upper gastrointestinal bleeding (UGIB). The bleeding risk of a PU is stratified according to the Forrest classification during endoscopy. High-risk ulcers are Forrest Ia (spurting hemorrhage), Ib (oozing hemorrhage), and IIa (visible vessel without hemorrhage), […]
Complications of acid-peptic disease: perforation, obstruction, and malignancy
Introduction The complications of peptic ulcer disease (PUD) have changed in their frequency and presentation,1–3 due to the use of drugs such as proton pump inhibitors and, more recently, potassium blockers, as well as the eradication of Helicobacter pylori. Intestinal perforation due to peptic ulcer is generally duodenal, and its diagnosis and treatment must be […]