Module 13

Peptic Ulcer Disease (PUD)

Gastic, Duodenal, Esophogeal

Hollowed out area that forms between the mucosal wall of the stomach, esophagus, or duodenum.

Most common in duodenum

Gram negative bacteria H pylori

S/S: epigastric tenderness, sharp burning aching gnawing pain, dyspepsia, n/v/d, constipation, belching, pyrosis, black stool

Duodenal: pain relieved with meals, pain 2-3 hours after meals, most common, dark tarry stool. H pylori, blood group O, middle age, weight gain

Gastric: pain increased with meals, pain 30 minutes-1 hour after meals, not as common, vomiting occurs. less RT h pylori, blood group A, late middle age, can be malignant, weight loss

Causes: smoking, h pylori, stress, genetics, alcohol consumption, NSAIDS

Perforation: pain in RUQ, abd distention, tachycardia, hypotension, tenderness

-Symptoms may come and go, may have no symptoms.

-Relief through antacids and food (duodenal)

Diagnostic Procedures

physical exam, endoscopy, biopsy of gastric mucosa, tissue specimen, CBC

H pylori

infects the lower part of the stomach, causes inflammation of the gastric mucosa, may lead to duodenal or gastric ulcer.

Triple therapy: PPI (omeprazole) , amoxicillin, clarithromycin

Quadruple Therapy: bismuth subsalicylate, metronidazole, tetracycline, PPI or ranitidine