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Seminar ON Peptic Ulcer: Presented By: Ms. Sweta Singh

This seminar discusses peptic ulcers, which are open sores in the lining of the stomach or intestines caused by an imbalance of protective and damaging factors. The presentation covers risk factors like smoking, definitions, clinical manifestations, diagnostic evaluations including endoscopy, management through medications and surgery, dietary recommendations, nursing care, complications, and patient education.

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shweta singh
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558 views26 pages

Seminar ON Peptic Ulcer: Presented By: Ms. Sweta Singh

This seminar discusses peptic ulcers, which are open sores in the lining of the stomach or intestines caused by an imbalance of protective and damaging factors. The presentation covers risk factors like smoking, definitions, clinical manifestations, diagnostic evaluations including endoscopy, management through medications and surgery, dietary recommendations, nursing care, complications, and patient education.

Uploaded by

shweta singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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SEMINAR

ON
PEPTIC ULCER

PRESENTED BY:
Ms. Sweta singh
 
INTRODUCTION
 Ulcers are defined as a breach in the mucosa of
the alimentary tract, which extends through the
muscular mucosa into the sub mucosa or deeper.

 Peptic ulcers are chronic most often lesions that


occur in any portion of GI tract exposed to
aggressive action of acid-peptic juices. Typically
occurs in stomach (gastric ulcer) and duodenum
( duodenal ulcer).
DEFINITION

 Peptic ulcer is the open sores that occurs in the


lining of the stomach or small intestines. It is
the erosion of the mucosal layer and break in
the lining of stomach.

 Peptic ulcer results from imbalance of


protective factors (bicarbonate and mucus) and
damaging factors (acids and pepsin).
RISK FACTORS

 Age group of 40-60 years


 Smoking
 Alcohol intake
 Spicy food
ETIOLOGY
 Excessive secretion of HCL (hydrochloric acid) in the
stomach may contribute to the formation of gastric
ulcers.

 H. Pylori infection.

 Prolonged use of NSAIDs(eg : paracetamol, ibuprofen


etc)
Cont.
  Zollinger-Ellison syndrome (ZES) consists of
severe peptic ulcers.

 Oesophageal ulcers occur as a result of the


backward flow of HCl from the stomach into
the oesophagus (gastroesophageal reflux
disease [GERD]).
CLINICAL MANIFESTATIONS

 Abdominal discomfort
 Epigastric pain
 Nausea
 Vomiting
 Dyspepsia
 Bloating
 Belching
 Pain after food intake
 GI bleeding
PATHOPHYSIOLOGY
 
DIAGNOSTIC EVALUATIONS
 History taking

 Physical examination

 Endoscopy: endoscopy is the preferred diagnostic


Procedure because it allows direct visualization of inflammatory
changes, ulcers, and lesions.

 Through endoscopy, a biopsy of the gastric mucosa and of any


suspicious lesions can be obtained.

 Stool for occult blood: stools may be tested periodically until they are
negative for occult blood.
Cont.
 Biopsy and histology: H. pylori infection may be determined by
biopsy and histology with culture.

 Breath test: During a breath test, swallow a pill, liquid or pudding


that contains tagged carbon molecules. If patient is having H.
pylori infection, carbon is released when the solution is broken down
in your stomach.

Your body absorbs the carbon and expels it when you exhale. You
exhale into a bag, and your doctor uses a special device to detect the
carbon molecules.

 Blood test: Serologic test for antibodies to the H. pylori antigen


MANAGEMENT
 Medical management

 Pharmocological method:
 Reduction of gastric secretion
 H2 antihistamines: eg. Ranitidine, cimetidine etc.
 Proton pump inhibitors(PPI): eg. Pantoprazole,
omeprazole etc
 Anticholinergics: eg. Propantheline, pirenzepine etc
 Prostaglandin analogues: eg. Misoprostol etc
Cont.
 Antacids
 Systemic: eg. Sodium bicarbonate, sodium citrate.
 Non-systemic: eg. Magnesium hypdroxide etc.

 Ulcer proctectives
 Sucralfate, colloidal bismuth subcitrate.

 Anti H. Pylori drugs:


 Amoxicillin, metronidazole, tetracycline etc.
 
Cont.
 Stress reduction and rest

 Smoking cessation
Smoking decreases the secretion of bicarbonate
from the pancreas into the duodenum, resulting in
increased acidity of the duodenum.
SURGICAL MANAGEMENT
 Vagotomy:
 Severing of the vagus
nerve. Decreases gastric
acid by diminishing
cholinergic stimulation to
the parietal cells, making
them less responsive to
gastrin. May be done via
open surgical approach,
laparoscopy, or
thoracoscopy
Cont.
 Pyloroplasty:
 A surgical
procedure in which
a longitudinal
incision is made
into the pylorus
and transversely
sutured closed to
enlarge the outlet
and relax the
muscle.
Cont.
 Billroth I
(Gastroduodenostomy) and
billroth II
(Gastrojejunostomy):

 Removal of the lower


portion of the antrum of the
stomach (which contains the
cells that secrete gastrin) as
well as a small portion of the
duodenum and pylorus. The
remaining segment is
anastomosed to the
duodenum (Billroth I) or to
the jejunum (Billroth II)
DIETARY MANAGEMENT

 Meat extracts, alcohol, coffee (including decaffeinated coffee, which also


stimulates acid secretion) and other caffeinated beverages, and diets rich in milk
and cream (which stimulate acid secretion) should be avoided.

 Diet compatibility becomes an individual matter: the patient eats foods that can
be tolerated and avoids those that produce pain.

 To neutralize acid by eating three regular meals a day.


 Small, frequent feedings are not necessary as long as an antacid or a histamine
blocker is taken.

 To avoid over secretion of acid try to take small and frequent meals and avoid
fasting.
NURSING MANAGEMENT

 Assessment
 The nurse should ask about history of vomiting or blood in
vomiting or stool.
  
 The nurse assesses vital signs and reports tachycardia and
 hypotension, which may indicate anaemia from GI
bleeding.
  
 The stool is tested for occult blood, and a physical
examination, including palpation of the abdomen for
localized tenderness, is performed as well.
cont,.

 Relieving pain (adviced medication should be


given on time)
 Relieving anxiety
 Increasing knowledge about the disease and its
treatment
 Provide small meals a day or small hourly
meals as ordered
 .monitor effectiveness of medications.
Nursing diagnosis:

 Acute pain related to the effect of gastric acid


secretion on damaged tissue.
 Anxiety related to coping with an acute
disease.
 Imbalanced nutrition related to changes in
diet.
 Deficient knowledge about prevention of
symptoms and management of the condition
COMPLICATION

 Hemorrhage
 Pyloric
 Perforation
Health education

 Advice patient to avoid smoking, alcohol


consumption if any present.
 Advice to avoid caffeine containing beverages and
food items.
 Avoid type of food which helps in elevating the
symptoms.
 Advice patient to take medication on time.
 Teach them to look for sign of GI bleeding,
perforation or any other complications.
 Tell them to take small divided meals .

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