1.  Definition it is a excavation (hallow-out area) that forms in the mucosal wall of the stomach, duodenum or esophagus

2.  Age  Gender  H pylori  Excessive HCL  Stess  Ingestion of milk, caffienated beverages  Smoking  Alcohol  Spicy food  Familial  Group O people  Chronic use of NSAID

3.  The gastroduodinal mucosal can not withstand the digestive action of gastric acid (HCL) and pepsin leading to erosion of mucosal or due to decrease resistance of the mucosa  Zollinger-Ellison stndrome (severe peptic ulcers)  Stress ulcers: proceeded by shock  Cushing ulcer: Head injuries  Curling ulcers: Excessive burn

4.  Pain: dull, gnawing pain, burning sensation in midepigastrum, usually relieved by eating,…,  Pyrosis  Vomiting  Constipation or diarrhea  Bleeding (occult blood, melena)

5.  Physical examination  Barium study  Endoscopy  Stool for occult blood  H-pylori test

6.  Pharmacological therapy  Antibiotics  Proton pump inhibitor  Histamine2 receptor inhibitor  Stress reduction and rest  Smoking cessation  Dietary modification  Surgical management

7.  ASSESSMENT  DIAGNOSIS  PLANNING  INTERVENTION  EVALUATION