45 years old male, the business executive of a well-established supermarket, came to the outpatient department with the complaint

of pain and discomfort in the upper abdomen for six months duration. He had recently been waking up in the middle of the night with abdominal pain. This was happening several nights a week. He gave no history of vomiting of blood or having blood in stool. He had been taking analgesics for joint pain. He was an occasional drinker and a chronic smoker. No mass or any other abnormality was noted on abdominal examination.

What is the most likely diagnosis? What investigations do you want to do? Differences between gastric ulcer and duodenal ulcer Predisposing factor for peptic ulcer Various investigation for peptic ulcer Helicobacter pylori Complication of peptic ulcer

Learning issue Anatomy - Nine regions of the abdomen - Gross anatomy of stomach and duodenum - Relation of stomach and duodenum - Blood supply and lymphatic drainage of stomach - Applied anatomy of stomach and duodenum Physiology Control of gastric acid secretion, mucosal barrier: mucosal defense mechanism and therapeutic intervention to reduce hyperacidity. What measures could be taken to reduce pain?

Biochemistry GI enzymes and digestion Absorption in GI tract H. pylori infection and acid secretion in the stomach