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Peptic Ulcer Disease (Pud) : Musah Abubakari RN, Apn, MSC, BSC Gcuc

Peptic ulcer disease (PUD) involves ulcers in the oesophagus, stomach, or duodenum, with duodenal ulcers being more common. Key factors include H. Pylori infection, alcohol, smoking, and prolonged NSAID use, leading to symptoms like epigastric pain and nausea. Diagnosis involves history, physical exams, and endoscopy, while treatment includes various antibiotic regimens and nursing care focused on patient education and monitoring.

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26 views11 pages

Peptic Ulcer Disease (Pud) : Musah Abubakari RN, Apn, MSC, BSC Gcuc

Peptic ulcer disease (PUD) involves ulcers in the oesophagus, stomach, or duodenum, with duodenal ulcers being more common. Key factors include H. Pylori infection, alcohol, smoking, and prolonged NSAID use, leading to symptoms like epigastric pain and nausea. Diagnosis involves history, physical exams, and endoscopy, while treatment includes various antibiotic regimens and nursing care focused on patient education and monitoring.

Uploaded by

rhalidu855
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

PEPTIC ULCER DISEASE (PUD)

MUSAH ABUBAKARI
RN, APN, MSc, BSc
GCUC
Introduction
• A peptic ulcer is an ulcer or excavation found in
the oesophagus, stomach or in the duodenum.
• A Peptic ulcer could be called gastric, duodenal,
or oesophageal depending on its location.
• However, peptic ulcers are more likely to be in
the duodenum than in the stomach.
• The ulcer could be acute or chronic.
Precipitating factors

H. Pylori – Found in 70% of patients with


gastric ulcer whiles 90% in duodenal ulcer
Alcohol
Smoking
Prolong use of NSAIDs
Severe physiologic Stress
Foods – spicy and caffeinated beverages
Pathophysiology
• The gastric and duodenal mucosal barrier
consists of a complex system made of
submucosal, epithelial and mucus elements
which helps protect their lining
• Imbalance between the aggressive factors (i.e.
acid and pepsin, NSAIDs) and this protective
barrier leads to a breakdown of the barrier.
• Breakdown of the mucosal barrier results in
diffusion of acid into the mucosa and
subsequently leads to an ulcer.
Signs and symptoms

Most people are asymptomatic. Commonly,


signs and symptoms are:
• Epigastric pain
• Vomiting
• Nausea
• Passage of melena stools
• Feeling bloated or full
NB: There are major differences between the
clinical manifestations of gastric and duodenal
ulcer – Students to read on them
Diagnosis

• Comprehensive history taking


• Physical examination
• Endoscopy – upper GI
• Barium x - rays
• Tests for H. Pylori e.g. urea breath test
Medical management
• Drugs- Tripple therapy, quadruple therapy is
recommended.
 Tripple therapy consists of a combination of
two antibiotics and one PPI.
 One PPI – omeprazole, esomeprazole
 Two Antibiotics include:
- Amoxicillin + Clarithromycin OR
- Amoxicillin + Metronidazole (flagyl)
 Quadruple therapy consists of bismuth, two
antibiotics and one PPI
Medical mgt
 Other combinations:
- Tripple therapy + antacid + antispasmodic
(buscopan)
- Tripple therapy + antacid + narcotic analgesic
(e.g. tramadol)
Nursing care
• Psychotherapy
- Reassurance
- Allay anxiety
• Patient education
- Educate patient on precipitating factors e.g. alcohol, NSAIDs
- Encourage him/her to avoid them
• Monitoring
- Check and record patient’s vital signs: T, P, R and BP
- Monitor intake & output
• Medications
- Serve and document all prescribed drugs e.g. Omeprazole
- Observe for the therapeutic and side effects of the drugs
• Diet
- Encourage less irritating or spicy foods e.g. beans, onions
- Serve meals in bits and at regular intervals
- Avoid fizzy and caffeinated drinks
• Blood transfusion prn: render all nursing care – vitals & education
Complications
• Severe anemia
• Intestinal perforations
• Stomach cancer
• Peritonitis

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