DEFINITION
- Peptic ulcers are open sores that develop on the lining of esophagus, stomach and the upper portion of small intestine.
CAUSES
• Drugs e.g NSAIDS, potassium supplement
• Bacteria e.g Helicobacter Pylori
• Smoking
• Anxiety
• Stervation
• Alcoholism
• Heredity
CLASSIFICATION
• Gastric ulcers: It occur on the lining of the stomach.
• Esophageal ulcers: It occur inside the hollow tube (esophagus) that carries food from your throat to your stomach.
• Duodenal ulcers: It occur on the upper portion of your small intestine (duodenum).
SIGNS AND SYMPTOMS
• Abdominal pain
• Epigastric/chest pain
• Nausea and Vomiting
• Bloating
• Anorexia
• Weight loss
• Hiccups
• Heartburn
• Hematemesis
• Malena
INVESTIGATIONS
• Blood analysis
• Stool analysis to fixed out H. Pylori
•History taking
• Physical examination
• X-ray
• MRI
• CT scan
• Abdominal USS
MEDICAL MANAGEMENT
• Antibiotic medications to kill H. pylori.
• Antacid: To neutralize HCL acid e.g Mist Magnesium Trisilicate, Gestid, Gecrol, polycrol, etc.
• Proton pump inhibitors: To reduce stomach acid by blocking the action of the parts of cells that produce acid e.g Omeprazole, Lansoprazole, rabeprazole, esomeprazole and pantoprazole.
• Histamine receptor antagonist (H-2): To reduce the amount of stomach acid released into the digestive tract, which relieves ulcer pain and encourages healing e.g Ranitidine, famotidine, cimetidine and nizatidine.
SURGICAL MANAGEMENT
In certain cases, surgery may be an option. For instance, if the ulcer continues to return, won’t heal, bleeds, or prevents food from leaving the stomach.
Surgery can include:
• Removing the ulcer
• Tying off bleeding blood vessels
• Sewing tissue from another site onto the ulcer
• Cutting the nerve that controls stomach acid production.
NURSING MANAGEMENTS
• Support the patient emotionally and offer reassurance.
• Administer prescribed medications.
• Provide six small meals a day or small hourly meals as ordered.
• Schedule care so that the patient gets plenty of rest.
• Monitor the effectiveness of administered medications, and also watch for adverse reactions.
• Assess the patient’s nutritional status and the effectiveness of measures used to maintain it.
• Weigh the patient regularly.
• Teach the patient about peptic ulcer disease, and help him to recognize its signs and symptoms.
• Review the proper use of prescribed medications, dicussing the desired actions and possible adverse effect of each drug.
• Instruct the patient to take antacids 1 hour after meals.
• Warn the patient to avoid aspirin containing drugs because they irritate gastric mucosa.
• Encourage the patient to make appropriate lifestyle changes
COMPLICATIONS
• Infection
• Scar tissue
• Internal bleeding
PREVENTION
• Avoid foods that irritate your stomach e.g spicy foods, citrus fruits, sour and hot meals and fatty foods are common irritants.
• Stop smoking: Heavy smokers are more likely to develop duodenal ulcers.
• Alcoholism: Heavy consumption of alcohol and has been shown to contribute to the development of ulcers.
• Avoid (NSAIDS including aspirin and ibuprofen) consumption, if necessary take them with food, as this may decrease your risk of irritating the lining of your stomach.
• Reduce stress
• Do not stay with hunger.
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7 Comments
Thanks.