RMA instruments
| 51 of 2024 | |
|---|---|
| 52 of 2024 |
Changes from previous instruments
ICD coding
- Gastric ulcer ICD-10 K25
Brief description
Gastric ulcers and erosions are non-malignant upper gastrointestinal pathologies affecting the stomach resulting in ulceration of the mucosal lining. If the size of the lesion is small and/or shallow (not extending into the muscularis mucosa) it is called an erosion. The SOP covers both gastric erosions and ulcers.
Confirming the diagnosis:
Confirmation of diagnosis requires upper gastrointestinal endoscopy, biopsy and histopathological examination. Histopathology is important to consider SOP exclusions have been considered.
It does not need to be symptomatic.
The relevant medical specialist is a gastroenterologist or general surgeon.
Additional diagnoses covered by these SOPs
- Acute gastric ulcer
- Bleeding gastric ulcer
- Chronic gastric ulcer
- Gastric ulcer
- Perforated gastric ulcer
- Gastric ulcers or erosions due to gastric foreign bodies
Conditions not covered by these SOPs
- Acute gastritis#
- Acute haemorrhagic gastritis #
- Chronic gastritis*
- Uraemic gastritis#
- Gastro-oesophageal reflux disease*
- Stomach neoplastic ulcer*
- Stomach perforations from external trauma such as stabbing, explosive blast injury or gunshot injury.
* another SOP applies
# non-SOP condition
Clinical onset
Once the diagnosis has been confirmed, clinical onset may be able to be backdated based on characteristic symptoms such as a burning or gnawing pain in the upper abdomen (often after meals), bloating, and/or nausea and vomiting. However, these symptoms are often non-specific and may be due to other conditions, such as gastro-oesophageal reflux disease.
Clinical worsening
Most ulcers resolve without treatment. Treatment for gastric ulcers will vary depending on the cause but can involve proton pump inhibitors (PPIs), H2 receptor antagonists, antibiotics (if H.pylori identified), and antacids. If an initially diagnosed gastric erosion or ulcer progresses to further complications such as gastrointestinal haemorrhage or perforation of the ulcer (surgical intervention will be required), this may be indicative of clinical worsening.