Peptic Ulcer Disese

• Peptic Ulcer Disease

-

- Is a term used to classify ulcerations on the mucosa of the esophagus, stomach and or duodenum

-

- Gastric ulcer and Duodenal ulcer are the most common type of PUD

PUD: Gastric Ulcer

- Ulceration in the mucosal lining of the layers of the stomach

- Most commonly found in the antrum

- Occurs more often in men and low socioeconomic group of about 40-55 y/o

- Caused by H. pylori bacteria

- weight loss

- pain intensifies with food

- PUD: Duodenal ulcer

- Commonly found in the first 2 cm of the duodenum

- Predisposing factor: smoking, alcohol use, stress

- Caused by H. pylori

- pain is releived by eating

- weight gain

-

- PUD: Diagnostics

-

- History

- Esophagogastroduodenoscopy - 1st choice for dx

- Upper GI series – barium swallow

- Cytology

- Gastric analysis

- PUD: Management

- H2 receptor antagonist

- Antacids

- Anticholinergic- decrease gastric motility and acid secretions

- Sucralfate- bind with protein in the ulcer site and serves as a protective coat. Taken 1hr before each meal

- Prostaglandin- anti secretory and protective liningof the stomach. should noy be used with pregnant women

- Antibiotics / metronidazole - to treat H. pylori

- Surgery

- Gastric Resection

- Total gastrectomy

- Billroth I

- Billroth II

- Pyloroplasty

- - Vagotomy – truncal / total, selective,

- PUD: Nursing Management

-

- Bland diet

- Small frequent meal, eat slowly

- Maintain adequate hydration

- Avoid stress as possible

- Monitor for and prevent bleeding

- Administer medications as ordered

- - Prepare for surgery if indicated