Peptic Ulcer Disease: erosion of the GI mucosa from the digestive action of HCl acid and pepsin; develops
only in acidic environment
1. Duodenal Ulcers-Mid epigastric area (small intestine)
H. pylori (from fecal-oral or oral-oral route)
“burning” or “cramp like” pain that occurs 2-5hrs after meals
Food alleviates the pain & antacids
2. Gastric Ulcer-Antrum/ Epigastrium (stomach)
H. pylori, NSAIDS, Acid reflux
“burning” or “gaseous” pain that occurs 1-2hrs after meals
Food worsens the pain
Perforation is a complication
Risk Factors:
• Medication induced injury such as corticosteroids w/ NSAIDs
• High alcohol & caffeine consumption
• Smoking
• Psychologic distress (stress and depression)
Complications of Chronic PUD: GI bleeding, perforation, and gastric outlet obstruction; these complications are
emergency situations and may need surgical intervention
Dx: Endoscopy-determines the presence and location of an ulcer
• Barium contrast study-to dx gastric outlet obstruction or for those who cannot undergo endoscopy
• H. pylori testing of breath, urine, blood, tissue
• CBC, liver enzyme studies, serum amylase, and stool testing for blood
Planning: decrease gastric acidity and enhance mucosal defense mechanisms
Interventions:
Adequate rest
smoking and alcohol cessation
diet modification if needed
long term follow up care
Stress management
Drug therapy-antibiotics for H. pylori, PPIs, adjunctive therapy-H2 receptor blockers, cytoprotective
drugs, antacids
TE:
Avoid peppers, carbonated beverages, broth meat extract, hot, spicy foods, caffeine
Avoid cigarettes and alcohol
Avoid OTC drugs (NSAIDs) unless approved by HCP
Do not interchange brands of PPI, antacids, or H2 receptor blockers that you can buy OTC without
checking with HCP
Follow prescribed drug therapy to prevent relapse
Report any of the following: h nausea or vomiting, h epigastric pain, bloody emesis or tarry stools
Stress management
Evaluation:
Have pain controlled without the use of analgesics
Commit to self-care and management of the disease
Free from complications
only in acidic environment
1. Duodenal Ulcers-Mid epigastric area (small intestine)
H. pylori (from fecal-oral or oral-oral route)
“burning” or “cramp like” pain that occurs 2-5hrs after meals
Food alleviates the pain & antacids
2. Gastric Ulcer-Antrum/ Epigastrium (stomach)
H. pylori, NSAIDS, Acid reflux
“burning” or “gaseous” pain that occurs 1-2hrs after meals
Food worsens the pain
Perforation is a complication
Risk Factors:
• Medication induced injury such as corticosteroids w/ NSAIDs
• High alcohol & caffeine consumption
• Smoking
• Psychologic distress (stress and depression)
Complications of Chronic PUD: GI bleeding, perforation, and gastric outlet obstruction; these complications are
emergency situations and may need surgical intervention
Dx: Endoscopy-determines the presence and location of an ulcer
• Barium contrast study-to dx gastric outlet obstruction or for those who cannot undergo endoscopy
• H. pylori testing of breath, urine, blood, tissue
• CBC, liver enzyme studies, serum amylase, and stool testing for blood
Planning: decrease gastric acidity and enhance mucosal defense mechanisms
Interventions:
Adequate rest
smoking and alcohol cessation
diet modification if needed
long term follow up care
Stress management
Drug therapy-antibiotics for H. pylori, PPIs, adjunctive therapy-H2 receptor blockers, cytoprotective
drugs, antacids
TE:
Avoid peppers, carbonated beverages, broth meat extract, hot, spicy foods, caffeine
Avoid cigarettes and alcohol
Avoid OTC drugs (NSAIDs) unless approved by HCP
Do not interchange brands of PPI, antacids, or H2 receptor blockers that you can buy OTC without
checking with HCP
Follow prescribed drug therapy to prevent relapse
Report any of the following: h nausea or vomiting, h epigastric pain, bloody emesis or tarry stools
Stress management
Evaluation:
Have pain controlled without the use of analgesics
Commit to self-care and management of the disease
Free from complications
