Peptic Ulcer

Peptic Ucer

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 pain 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 ache. Belching, vomiting, weight loss, and a lack of appetite are some additional symptoms. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of people.

Causes

• Pylori,
• Stress,
• NSAIDs,
• Diet.

Sign and Symptoms

• Abdominal pain, classically epigastric strongly correlated to mealtimes. In case of duodenal ulcers, the pain appears about three hours after taking a meal,
• Bloating and abdominal fullness,
• Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus - although this is more associated with gastroesophageal reflux disease),
• Nausea, and copious vomiting,
• Loss of appetite and weight loss,
• Hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric ulcer, or from damage to the esophagus from severe/continuing vomiting,
• Melena (tarry, foul-smelling feces due to presence of oxidized iron from hemoglobin).

Diagnosis

• History taking and physical examination,
• Endoscopy,
• Barium studies in upper GI tract,
• Stool for occult blood,
• Gastric secretion examination.

Treatment

• Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists before endoscopy is undertaken.
• People who are taking nonsteroidal anti-inflammatories (NSAIDs) may also be prescribed a prostaglandin analog (misoprostol) in order to help prevent peptic ulcers.
• Perforated peptic ulcer is a surgical emergency and requires surgical repair of the perforation. Most bleeding ulcers require endoscopy urgently to stop bleeding with cautery, injection, or clipping.
• Vagotomy.
• Pyloroplasty.

Nursing Management

• Medications,
• Know the dosage, administration, action and side effects,
• Tell to patient to complete all prescribed drugs,
• Ask the patient to keep antacid available for all the time,
• Avoid use of over the counter H2 receptors antagonists,
• Use acetaminophen for routine pain relief,
• Avoid use of NSAIDs.

• Diet

  • Eat the balanced meals a day,
  • Eat between meals snacks if this helps relief pain or control pain,
  • Avoid bedtime snacks,
  • Eat slowly and chew food thoroughly,
  • Avoid use of alcohol.
  • Smoking
    • Stop smoking
    • Explore community support for smoking cessation
• Stress Reduction
  • Participate in recreation and hobbies that promote relaxation,
  • Participate in a moderate exercise program for promotion of well-being,
  • Provide for maximum rest during healing.

Complications

• Hemorrhage,
• Perforation,
• Penetration.
• Pyloric Obstruction.