Peptic ulcer

Peptic Ulcer:

Definition:

A peptic ulcer is an open sore or erosion that forms on the lining of the stomach, upper part of the small intestine (duodenum), or esophagus due to the breakdown of the protective mucosal layer.

Causes:

- Helicobacter pylori infection (most common cause)

- Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs)

- Smoking and alcohol consumption

- Stress and genetic factors

Types:

- Gastric ulcers: Occur in the stomach lining.

- Duodenal ulcers: Form in the duodenum, the upper part of the small intestine.

Pathophysiology:

Due to etiology factor

Excessive amount of hcl produce in gastric

Damage the stomach wall

Acid enter in stomuch wall

Ulcer formation 

Gasric ulcer

Signs & Symptoms:

- Burning or gnawing abdominal pain, typically between meals or at night.

- Nausea, vomiting, and bloating.

- Weight loss and loss of appetite.

- Dark, tarry stools (indicating bleeding).

- Severe cases may cause complications like perforation or obstruction.

Diagnostic Evaluation:

- Upper gastrointestinal endoscopy (gold standard) to visualize the ulcer.

- Biopsy for H. pylori testing.

- Barium contrast X-ray or CT scan to detect ulcers not visible on endoscopy.

- Stool tests to check for occult blood and H. pylori antigens.

Pharmacology Management:

- Proton pump inhibitors (PPIs) to reduce stomach acid production.

- H2 receptor blockers to decrease acid secretion.

- Antibiotics (in case of H. pylori infection).

- Antacids for symptomatic relief.

Non-pharmacology Management:

- Lifestyle changes like quitting smoking and reducing alcohol intake.

- Avoiding NSAIDs or using alternative medications under medical guidance.

- Stress management techniques.

Nursing Management:

-Nursing Diagnosis: 

Acute Pain related to gastric irritation and inflammation.

- Monitor vital signs, abdominal pain, and signs of bleeding.

- Provide appropriate pain relief measures.

- Educate the patient about medication adherence and lifestyle modifications.

- Monitor and encourage dietary changes to promote healing.

- Emotional support and stress reduction techniques.