Peptic Ulcer

Subject: Medical and Surgical Nursing I (Theory)

Overview

An ulcer in the stomach, the first section of the small intestine, or rarely the lower esophagus is referred to as peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer. A duodenal ulcer is found in the first section of the intestines, while a gastric ulcer occurs in the stomach. Its causes include the use of long-term nonsteroidal anti-inflammatory medicines (NSAIDs), such as aspirin and ibuprofen, as well as infection with the Helicobacter pylori (H. pylori) bacterium. Its symptoms include dull stomach ache, weight loss, a lack of appetite due to pain, nausea, or vomiting. Both surgical and nonsurgical methods can be used to treat it. Avoid aspirin, which is an anticoagulant, and foods and beverages that contain acid enhancing caffeine (colas, tea, coffee, chocolate), along with decaffeinated coffee. Encourage patient to eat regularly spaced meals in a relaxed atmosphere; obtain regular weights and encourage dietary modiï¬Âcations.

An ulcer in the stomach, the first section of the small intestine, or rarely the lower esophagus is referred to as peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer. A duodenal ulcer is found in the first section of the intestines, while a gastric ulcer occurs in the stomach. The most typical symptoms are upper abdominal discomfort that wakes you up at night or upper abdominal pain that gets better after eating. The discomfort is frequently described as a burning or aching sensation. Belching, vomiting, weight loss, and a lack of appetite are some additional symptoms.

 Pathophysiology

An excavation that forms in the mucosal wall of the stomach, pylorus, duodenum, or esophagus is known as a peptic ulcer. Depending on where it is, it may be referred to as a gastric, duodenal, or esophageal ulcer. It is brought on by the mucous membrane's surrounding area eroding.

The bacterial infection Helicobacter pylori has been linked to peptic ulcers. People between the ages of 40 and 60 had the highest incidence. Women experience menopause at a rate that is essentially identical to men.

 Causes

  • Infection with the bacterium Helicobacter pylori (H. pylori).
  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.
  • Excess acid (hyperacidity) in the stomach, which may be related to genetics, lifestyle (stress, smoking), and certain foods.
  • Zollinger-Ellison syndrome, a rare disease that makes the body produce excess stomach acid.

 Symptoms

  • Dull pain in the stomach
  • Weight loss
  • Not wanting to eat because of pain
  • Nausea or vomiting
  • Bloating
  • Burping or acid reflux
  • Heartburn (burning sensation in the chest)
  • Pain improves when you eat, drink, or take antacids.

 Diagnosis

  • Barium X-ray:
    • A thick white liquid (barium) that you drink helps the stomach and small intestine show up on X-rays.
  • Endoscopy:
    • A thin, lighted tube is inserted through the mouth and into the stomach to look for the presence of an ulcer.
  • Endoscopic biopsy:
    • A piece of stomach tissue is removed so it can be analyzed.

 Treatment

Non-surgical

  • H2 blockers:
    • To prevent your stomach from making too much acid.
  • Proton pump inhibitors:
    • Blocks the cells that produce acid.
  • Over-the-counter antacids: 
    • To help neutralize stomach acid.
  • Cytoprotective agents:
    • To protect the lining of the stomach and small intestine, such as Pepto-Bismol.

 Surgical

  • An oval of the entire ulcer.
  • Taking tissue from another part of the intestines and sewing it over the ulcer site.
  • Tying off a bleeding artery.
  • Cutting off nerve supply to the stomach to reduce the production of stomach acid.

 Nursing management

  • Administering prescribed drugs.
  • Avoid aspirin, an anticoagulant, along with acid-enhancing caffeine-containing foods and beverages (colas, tea, coffee, chocolate), as well as decaffeinated coffee.
  • Encourage the patient to take meals at regular intervals while remaining at ease, to get regular weights, and to make dietary changes.
  • Promote relaxation strategies.
  • Describe diagnostic procedures and when to take drugs.
  • Engage in soothing conversation, offer assistance in detecting stressors, and describe appropriate coping mechanisms and relaxation practices.
  • Encourage family members to assist with caregiving and offer emotional support.
  • help the patient comprehend their disease and the causes or aggravating circumstances.
  • Inform the patient of the name, dosage, frequency, and potential side effects of any prescription medications. Determine which medications the patient should not take, such as aspirin.
  • Inform the patient about specific foods, such as coffee, tea, colas, and alcohol, which have the potential to produce acid and irritate the gastric mucosa.
  • Encourage the patient to eat regularly, unhurriedly, and without going overboard.
  • Inform the patient that smoking can impede the healing of an ulcer and provide referrals to programs that can help them quit.

 Complication

  • Sudden, sharp pain that doesn’t stop
  • Black or bloody stools
  • Bloody vomitus
  • Vomit that looks like coffee grounds

References

  • akademics.net/Q/52197/Peptic+ulcer
  • allaboutheaven.org/overload/282/229/heartburn-and-ulcers
  • books.google.com/books?isbn=0781785928
  • easynotecards.com/notecard_set/62882
  • healthmedicalinfohmi.blogspot.com/2015/04/peptic-ulcer-disease-pud.html
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • nairaland.com/3181759/how-handle-ulcer-early-advanced
  • nurseslabs.com › Notes › Medical-Surgical Nursing
  • thevisualmd.com/searchimg/?idu=1083612495&q=%20ulcer&p=1
     
Things to remember
  • Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer,
  • The pain is often described as a burning or dull ache. 
  • Other symptoms include belching, vomiting, weight loss, or poor appetite.
  • Explain diagnostic tests and administering medications on schedule.
  • Encourage patient to eat regular meals in a relaxed setting and to avoid overeating.
  • Explain that smoking may interfere with ulcer healing; refer a patient to programs to assist with smoking cessation.
Questions and Answers

Peptic ulcer

An ulcer in the stomach, the first section of the small intestine, or rarely the lower esophagus is referred to as peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer. A duodenal ulcer is found in the first section of the intestines, while a gastric ulcer occurs in the stomach. The most typical symptoms are upper abdominal discomfort that wakes you up at night or upper abdominal pain that gets better after eating. The discomfort is frequently described as a burning or aching sensation. Belching, vomiting, weight loss, and a lack of appetite are some more symptoms.

 

Causes

  • Bacterial infection with Helicobacter pylori (H. pylori)
  • Use of nonsteroidal anti-inflammatory medicines (NSAIDs) over an extended period of time, such as aspirin and ibuprofen
  • Excessive stomach acid (hyperacidity), which may be influenced by heredity, lifestyle factors (stress, smoking), and particular meals
  • Zollinger-Ellison syndrome, a rare condition that causes an excess of stomach acid to be produced

Symptoms

  • Dull abdominal discomfort
  • Slim down
  • Pain preventing you from wanting to eat
  • Dizziness or vomiting
  • Bloating
  • Gurgling or heartburn
  • Heartburn (burning sensation in the chest)
  • When you consume food, liquids, or antacids, pain decreases.

Causes

  • Bacterial infection with Helicobacter pylori (H. pylori)
  • Use of nonsteroidal anti-inflammatory medicines (NSAIDs) over an extended period of time, such as aspirin and ibuprofen
  • Excessive stomach acid (hyperacidity), which may be influenced by heredity, lifestyle factors (stress, smoking), and particular meals
  • Zollinger-Ellison syndrome, a rare condition that causes an excess of stomach acid to be produced

Symptoms

  • Dull stomach discomfort
  • Loss of weight
  • Not wanting to eat due to discomfort,
  • Bloating,
  • Burping, acid reflux,
  • Heartburn (burning sensation in the chest)
  • When you consume food, liquids, or antacids, discomfort decreases.

Nursing management

  • Administering prescribed drugs.
  • Avoid aspirin, an anticoagulant, along with acid-enhancing caffeine-containing foods and beverages (colas, tea, coffee, chocolate), as well as decaffeinated coffee.
  • Encourage the patient to take meals at regular intervals while remaining at ease, to get regular weights, and to make dietary changes.
  • Promote relaxation strategies.
  • Describe diagnostic procedures and when to take drugs.
  • Engage in relaxing conversation, offer assistance in identifying stressors, and describe effective coping mechanisms and relaxation techniques.
  • Encourage family members to assist with caregiving and offer emotional support.
  • Help the patient comprehend their condition and the causes or aggravating factors.
  • Inform the patient of the name, dosage, frequency, and potential side effects of any prescription medications. Determine which medications the patient should not take, such as aspirin.
  • Inform the patient about specific foods, such as coffee, tea, colas, and alcohol, which have the potential to produce acid and irritate the gastric mucosa.
  • Encourage the patient to eat regularly, unhurriedly, and without going overboard.
  • Inform the patient that smoking can impede the healing of an ulcer and provide referrals to programs that can help them quit.

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