peptic ulcers

 A peptic ulcer is an ulceration in the mucosal lining of the esophagus, stomach, and duodenum part of the small intestine.PUD normally occurs by an infectious bacteria named H Pylori [halicobector pylori]

Types of peptic ulcers

1. oesophageal ulcers:- occurs at the mucosal lining of the esophagus

 2. Gastric ulcers:- occurs at the mucosal lining of the stomach

 3. Duodenal ulcers:- occurs at the mucosal lining of the duodenal part of the small intestine.

CAUSES 

Different factors can cause ulceration in the esophagus, stomach, and duodenal. These includes

• Infection by bacteria H. Pylori
• Frequent use of anti-inflammatory drugs like Asprin, Ibuprofen, etc.
• Increase secretions of gastric juice
• Smoking
• Alcoholism
• Excessive stress
• Radiation Therapy
• Stomach cancer

   Symptoms of PUD

         -: Most common symptoms are:-

• Gastric pain
• Heartburn 
• Abdominal pain which extends to naval to chest

         -: Other common signs of PUD:-

• Nausea
• Vomiting 
• Heamatomasis
• Anorexia
• Constipation 
• Dark-colored stool [ Malena]
• Weight loss
• Indigestion
• Diarrhea

Test and examination for the diagnosis of peptic ulcer

• Upper endoscopy:-In  this procedure doctor insert endoscope by the throat and visualize the mucosal lining of the esophagus and stomach
• Barium swallow test:- In this test dr. gives you barium to drink and after drinking it x-ray is done, of the esophagus, stomach, and duodenal part 
• Stool test 
• Blood test for recognition of H.Pylori 

  Treatment of peptic ulcers

 

   -: Medical treatment:-

• H2 Receptor blocker antagonist :- Ranitidine,Cemitidine
• Protone pump inhibitors:- Omeprazole, Rebeperazol
• Anticholinergic drug:-  Glucopyrrolate, Atropine
• Antacid drugs:- Dygin, Aluminum Hcl
• Antimicrobial drug:- Amoxillin, Metronidazole

-: Surgery associated with the treatment of peptic ulcers:-

• Vagotomy:- In this, some parts of the vagus nerve is cut  to reduce the stimulation for Hcl secretions
• Gastrotomy:- removal of part of the stomach which is affected
• Pyeloplasty;- In this, an incision is made in the pylorus part of the stomach and removal of damaged mucosa from there

-: NURSING DIAGNOSIS on Peptic ulcer:-

• Acute abdominal pain R/T Mucosal irritation or high HCL secretion
• Risk of shock R/T Heamatomasis
• Altered nutritional level R/T Anorexial condition, mucosal irritation or abdominal  pain
• Risk of hypovolemia R/T Vomiting and diarrhea
• Anxiety/fear R/T Change in the environment of the client.