ROSH Gastrointestinal Practice Exam

What is a principal risk factor for peptic ulcer disease?

1. Alcohol consumption

2. Emotional stress

3. Helicobacter pylori infection

4. High-fat diet

The correct answer is: Helicobacter pylori infection

Helicobacter pylori infection is considered a principal risk factor for peptic ulcer disease due to its well-established role in both the development and exacerbation of gastric and duodenal ulcers. The bacteria can weaken the protective mucous lining of the stomach and duodenum, leading to inflammation and ulcer formation. Approximately 70-90% of individuals with peptic ulcers are found to be infected with H. pylori, which highlights its significance in the pathogenesis of these ulcers. While other factors like alcohol consumption, emotional stress, and high-fat diets can influence gastrointestinal health and potentially contribute to ulcer formation, they do not have the same direct and strong correlation with peptic ulcer disease as H. pylori does. Stress may exacerbate symptoms, but it does not initiate ulcer formation in the way that H. pylori does. Similarly, while alcohol can irritate the gastrointestinal lining, it is not the primary cause of peptic ulcers. High-fat diets may affect overall health but lack a direct link to ulcer pathogenesis as compared to H. pylori infection. Thus, H. pylori remains the primary focus when assessing the risks for peptic ulcer disease.