Peptic Ulcer

PEPTIC ULCER DISEASE

Increase secrete acid than normal Decrease level of acids

ASSESSMENT

 PHYSICAL EXAMINATION may reveal : d. Pain e. Epigastric tenderness f. Abdominal distention g. hemorrhage

DIAGNOSIS

 Barium study -Barium studies should be the first line of defense in diagnosing problems that can occur following surgery for reflux disease, a new study shows.  Endoscopy -may reveal lesions it size and location

 Stools  Gastric secretory studies - diagnosing alchorhydria (lack of hcl acid in digestive secretions of the stomach).  Biopsy  Helicobacter pylori infection -determine by endoscopy and histologic examination

MEDICAL MANAGEMENT

 ANTIBIOTICS -metrodinazole , amoxicillin , clarithromycin -to eradicate h.pylori -surgical intervention  PROTON PUMP INHIBITORS -clansoprazole , omeprazole

• Proton pump inhibitors (or "PPI"s) are a group of drugs whose main action is pronounced and long-lasting reduction of gastric acid production.

Bismuth salts -suppress or eradicate h.pylori Smoking reduction and rest Dietary modification Surgical procedure -vagotomy -Billroth I and Billroth II

Vagotomy -A vagotomy is a surgical procedure that is performed only in humans. It is resection (removal of, or at least severing) of part of the vagus nerve.

 Antrectomy (billroth I) - is the resection, or surgical removal, of a part of the stomach known as the antrum. The antrum is the lower third of the stomach that lies between the body of the stomach and the pyloric canal, which empties into the first part of the small intestine.

 Gastrojejunostomy (Billroth II) -GI surgery A procedure in which the duodenum is excised or bypassed and the stomach is end-to-end anastomosed to the jejunum  FOLLOW UP CHECK UP

NURSING INTERVENTIONS

 Relieving pain -avoid aspirin , foods and beverages that contain caffeine and de caffeinated coffee

-relaxation techniques to manage stress and pain  Reducing anxiety  Maintaining optimal nutritional status -assess for malnutrition and weight loss

 Monitoring and managing potential complications  Promoting home care

Thank you very much!!!!!!! Delacruz mariel a. Bsn 3c2-8i Our lady of fatima university