...------------------------------------------------- Peptic ulcer A peptic ulcer, also known as PUD or peptic ulcer disease,[1] is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm. As many as 70–90% of such ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach; however, only 40% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such as aspirin, ibuprofen, and other NSAIDs.[2] Four times as many peptic ulcers arise in the duodenum—the first part of the small intestine, just after the stomach—as in the stomach itself. About 4% of gastric ulcers are caused by a malignant tumor, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign. ------------------------------------------------- ------------------------------------------------- [edit]Classification By Region/Location * Duodenum (called duodenal ulcer) * Oesophagus (called esophageal ulcer) * Stomach (called gastric ulcer) * Meckel's diverticulum (called Meckel's diverticulum ulcer; is very tender with palpation) Modified Johnson Classification of peptic ulcers: * Type I: Ulcer along the body of the stomach, most often along the lesser curve at incisura angularis along the locus minoris resistantiae. * Type II: Ulcer in the body in combination with duodenal ulcers. Associated with...
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...|Loperamide, Imodium; anti- diarrheal |2 mg PO per loose |Inhibits peristalsis and prolongs transit |Relief of diarrhea |Loose stool | | |stool PRN up to 20 |time by a direct effect on nerves, reduces| | | | |mg/day |fecal volume, increases fecal viscosity | | | |calcium carbonate/ |30 cc PO Q 4hrs PRN |neutralizing the acid in the stomach. |Reduction in gastric acid |Upset GI | |magnesium carbonate, Mylanta; | | | | | |mineral/electrolyte supplement | | | | |...
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... oral Generic Name Brand Name Classifications Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsiblities Sodium Bicarbonate Arm & Hammer Baking Soda, Neut, Soda Mint Acidifiers and alkalinizing Restores buffering capacity of the body and utilizes excess acid. >cardiac arrest >metabolic acidosis >systemic or urinary alkalinization >antacid >Contraindicated to pts w/ metabolic or respiratory alkalosis & in those with hypocalcaemia in w/c alkalosis may produce tetany, hypertension, seizures or heart failure >Also contraindicated in pts losing chlorides bec. of vomiting or continuous GI suction & receiving diuretics that produce hypochloremic alkalosis CNS: tetany CV: edema GI: gastric distention, flatulence Metabolic: hypokalemia, hyponatremia >Monitor pt closely for toxicity and affectiveness >Avoid using NaHCO3 and enteric-coated drugs together. DRUG STUDY Prescribed and Recommended Dosage, Frequency, and route of Administration 100mg OD, oral Generic Name Brand Name Classifications Mechanism of Action Indication Contraindication Adverse Reaction Nursing Responsiblities Allopurinol Aloprim, ApoAllopurinol + Zyloprim Hyperuricemia and gout preparations Reduces uric acid production by inhibiting xanthine oxidase >Gout or hyperurocemia >Hyperuricemia caused by malignancies >To prevent acute gout attacks >To prevent uric acid nephropathy during cancer chemotherapy >Recurrent calcium...
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...Peptic Ulcers and Its Treatment Introduction Peptic ulcers are open sores that develop in the stomach lining. It is also develop in the lining of duodenum, or esophagus as a result of erosion that formed by acidic digestive juices which corroding the lining of the digestive system. There are three types of peptic ulcers, which are gastric ulcers, duodenal ulcers and esophageal ulcers. Gastric ulcers are ulcers that develop inside the stomach. Duodenal ulcers are ulcers that develop in the upper portion of the small intestine, called duodenum. Esophageal ulcers are ulcers that develop inside the esophagus. The etiology of peptic ulcer is not clearly known. Infection of stomach with the bacterium Helicobacter pylori or use of certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) is contributed to ulcer formation. In gastric ulcer, the acid secretion is normal or low. Generally acid secretion is high or normal in duodenal ulcer. The treatment of peptic ulcer is divided into 4 classes: agents that reduce gastric acid secretion, agents that neutralize gastric acid, agents that promote mucosal defense and anti-H. pylori drugs. Treatment Pharmacological measures for the management of peptic ulcers 1. Reduction of gastric acid secretion Histamine (H2) receptor antagonists Example: cimetidine, nizatidine, ranitidine, and famotidine They are highly selective H2 receptor antagonists. They work by binding to H2 receptors which are located on the basolateral...
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...Medications 1. Protonix (pantoprazole) – antiulcer agent (proton-pump inhibitors) a. Indications – Erosive esophagitis associated with GERD. Decrease relapse rates of daytime and nighttime heartburn symptoms on patients with GERD. Pathologic gastric hypersecretory conditions. b. Action – Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Diminished accumulation of acid in the gastric lumen, with lessened acid reflux. Healing of duodenal ulcers and esophagitis. Decreased acid secretion in hypersecretory conditions. Pg. 990 2. SynTHROID (levothyroxine) – hormones (thyroid preparations) a. Indications – Thyroid supplementation in hypothyroidism. Treatment or suppression of euthyroid goiters and thryroid cancer. b. Action – Replacement of or supplementation to endogenous thyroid hormones. Principal effect is increasing metabolic rate of body tissues: Promote gluconeogenesis, increase utilization and mobilization of glycogen stores, stimulate protein synthesis, promote cell growth and differentiation, aid in the development of the brain and CNS. Contain T3 (triiodothyronine) and T4 (thyroxine) activity. Replacement in hypothyroidism to restore normal hormonal balance. Suppression of thyroid cancers. Pg. 1219 3. Dulcosate Sodium (colace) – laxative (stool softener) a. Indications – prevention of constipation (in patients who should avoid straining...
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...patients with gastritis and ulcers. It’s physiology and environment of choice both create a unique dichotomy which ultimately allows it the survive in the human body for, possible, the whole patient's lifetime. Furthermore, its epidemiology has enabled H. Pylori to seemingly go undetected as the cause for a variety of illness such as duodenal ulcer and stomach cancer. All of these factors have created a versatile pathogen. Before the discovery of H. Pylori the conventional thought of bacteria was that none could live in the acidic environment...
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...are related to hypo motility. Paralytic ileus and gastric distention develop as a result of decreased GI motility. Stress ulcers develop because of excessive release of hydrochloric acid in the stomach. Protonix is frequently used to prevent the occurrence of ulcers in the initial phase. 5. During an injury, the spinal column and the spinal cord can be injured anywhere along their length. The majority of the damage to the spinal cord occurs at the time of injury, but further damage can be caused by improper handling of the unstable spine and by the disruption of the blood supply, which can cause hypoxia and necrosis. Immediately following SCI, spinal shock occurs in the portion of the spinal cord that is injured and results in a complete loss of all motor, sensory, reflex, and autonomic function below the level of the injury. This loss is manifested in loss of bowel and bladder tone and peripheral vascular tone, which result in bladder distention, paralytic ileus, flaccid paralysis, and hypotension. After a period that varies from hours to months, but which usually lasts for 1 to 6 weeks, the spinal neurons gradually regain their excitability and the period of spinal shock ends. 6. Physical therapy: Range of motion exercises, Mobility training, Muscle strengthening. Occupational therapy (Splints, activities of daily living training) Bowel and bladder training Autonomic dysreflexia prevention Pressure ulcer prevention Recreational...
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...Peptic Ulcer Peptic ulcers are open sores that develop on the inside lining of your esophagus, stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is abdominal pain. Peptic ulcers include: Gastric ulcers that occur on the inside of the stomach Esophageal ulcers that occur inside the hollow tube (esophagus) that carries food from your throat to your stomach Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum) CAUSES Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the esophagus, stomach or small intestine. The acid can create a painful open sore that may bleed. Your digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer. Common causes include: A bacterium. Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, H. pylori causes no problems, but it can cause inflammation of the stomach's inner layer, producing an ulcer. It's not clear how H. pylori spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water. Regular use of certain pain relievers. Certain over-the-counter and prescription pain medications can irritate or inflame...
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...hyperthyroid Graves-hyper-exophthalmos vs myxedema-hypo- dull puffy skin Thyroid medication -hyperthyroid -tapazole vs hypothyroidism-levothyroxine Diabetes insipidus Addisons hypocorticosteroids- vs cushings hypercorticosteroids – symptoms increase blood sugar, wound instability Addisons is lack of adrenal corticosteroids -also get gastric ulcers with the meds you take Correct fluid and electrolyte imbalance, weight loss , bronze face Cushings- corticosteroid excess, mostly ACTH secreting pituitary adenoma, weight gain, moon face , treatment is to normalize hormone secretion (Nizoral), hydrocortisone or prednisone-causes ulcers- may be needed Titration before stoping steroids- taper off and take with food – matacium or potassium Blood test for ulcer disease- hemoglobin hematocrit Hyperthyroidism--- T3 and T4 increase TSH decrease Hypothyroidism----T3 and T4 decrease TSH increase Hyper-tapazole Hypo- levothyroxine (ts/synthroid) PTU and Tapamax stop thyroid Addisons disease- no BP, bronze color Predisone causes gastric ulcers PUD/GERD drugs – Carafate dosing------pepcid, antacid, Lifestyle changes for GERD PUD(treat, cause)- vs GERD (stop food going up) Antibiotics for H. Pylori- PPI, cytotec Drugs for...
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...consequences of smoking and nicotine use on the GI system. Application to Gastrointestinal A&P The author describes the anatomy, physiology, and pathophysiology of the GI tract as it pertains to smoking and nicotine. What Did I Learn Within the stomach, smoking has been shown to prevent the production of bicarbonate ions by reducing prostaglandin synthesis, which controls bicarbonate secretion. Bicarbonate ions are important to the stomach mucosa because they help to form “a pH gradient, from strongly acidic on the luminal surface to neutral at the mucosa.” The absence of sufficient bicarbonate ions makes the mucus layer of the stomach susceptible to erosion, potentially leading to the development of peptic ulcers. It is important to note that peptic ulcer susceptibility can be exacerbated by...
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...bleed are alcoholism, smoking, excessively use of NSAIDs, and infection of helicobacter pylori. 2. What are the differences between an upper and lower GI bleed? There are many differences between an upper GI and lower GI bleed including causes and physical presentation. For upper GI bleeding, the causes are a duodenal and gastric ulcer, gastric varices, and Mallory-Weiss tear (Sole, Klein, & Moseley, 2013). The causes of lower GI bleeding include cancer, hemorrhoids, polyps, an inflammatory disorder, diverticulosis, and vascular ectasias (Sole, Klein, & Moseley, 2013). The significant sign and symptom that differentiate between upper and lower GI bleeding are the color of the blood. In upper GI bleeding, the blood appears dark and coffee grounds which called hematemesis. In the opposite, the lower GI bleeding has the bright red blood appearance. Other signs and symptoms of upper GI bleeding include hypovolemic shock, discomfort of the abdominal, and black-foul stool which called melena (Sole, Klein, & Moseley, 2013). 3. How are these conditions diagnosed? The diagnostic tests include CBC, serum electrolyte, hematology, ABGs, and gastric aspirate (Sole, Klein, & Moseley, 2013). The diagnostic tests will show the increase of WBC, platelet, potassium, sodium, BUN and creatinine. The arterial blood gasses will show respiratory alkalosis or metabolic acidosis (Sole, Klein, & Moseley, 2013). There is also a decrease of Hgb levels which there is a presence...
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... 2. The most common cause of mechanical bowel obstruction is: Adhesions. 3. Crohn disease is most often diagnosed in which age group? 15-25 years. 4. Which of the following clinical findings would suggest an esophageal rather than an oropharyngeal cause of dysphagia? Chest pain during meals. 5. What does the pathophysiology of chronic gastritis include? Atrophy of the gastric mucosa with decreased secretions. 6. Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of: Appendicitis. 7. How may a fistula form with Crohn’s disease? Recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops. 8. A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is: Inhibiting mucosal prostaglandin synthesis. 9. Prolonged or severe stress predisposes to peptic ulcer disease because: Of reduced blood flow to the gastric wall and mucous glands. 10. A 50-year-old male complains of frequently recurring abdominal pain, diarrhea, and bloody stools. A possible diagnosis would be: Ulcerative Colitis. 11. What is a common cause of gastroenteritis due to Salmonella? Raw or undercooked poultry or eggs. 12. T-cell lymphoma was diagnosed in a 55-year-old man who had a lengthy history of intestinal disease...
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...Unexpected On the morning of February 29, 2012 I was out shopping getting ready for my husband’s welcome home party. It had been almost a year since the last time I had seen him, you see he was deployed overseas just 1 month after our wedding so you could imagine how excited and anxious I was for him to return home. I was all done with my shopping at my favorite store Burlington when I left the store and was getting into my vehicle I heard a loud pop, it came from my stomach I really didn’t think nothing of it until the pain started getting so unbearable I couldn’t catch my breath. I had to drive all the way home which was about 10 miles it literally seemed like an hour drive. You see I had gastric bypass 10 years ago and ever since my surgery I have had some stomach issues such as ulcers and gastritis due to the surgery my stomach has become very sensitive. I finally got home and my first reaction was to lay down in bed I figured the pain would just pass must of been something I ate, it’s not unusual for me to feel sick to my stomach sometimes. Well that was the biggest mistake I could have ever made my body went into shock and I couldn’t move or call for help I was paralyzed in bed I was so scared and in pain felt like I was laying there in those conditions forever. That afternoon my husband was trying to get ahold of me and I wouldn’t answer which was rare I always answered his calls since we didn’t get to speak much cause he was overseas so he called his mother to go to my...
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...Effectiveness of Antacid Tablets by Trisha Dwivdi, 2002 Abstract The purpose of this project was to figure out if antacid tablets are effective in neutralizing the human stomach. Effective was defined to mean that the tablet did not neutralize too much of the solution or too little of the solution compared to other brands. I titrated a solution that had a pH that was similar to the human stomach and tested four brands of popular antacid tablets. The four brands were Pepcid AC®, Zantac 75®, Rolaids®, and Alka Seltzer®. Rolaids® was the only brand that did not neutralize the solution. The other three antacid tablets did work and I decided that antacid tablets are effective in neutralizing the human stomach since they did not neutralize all of the stomach solution or they did not just neutralize a small amount of it. This experiment was all relative to the other tablets, because I had no background information on what defines an antacid tablet to be effective so I had to base it on the results of the other tablets. Rolaids® took an irregular amount of stomach solution compared to the other tablets to neutralize, so I based my results on this observation. Introduction The purpose of doing this project was to figure out if antacid tablets work effectively since there are many tablets out there on the market. I predicted that the antacid tablets will neutralize the stomach solution I made and therefore be effective. I worked in the Breck School Science Lab under...
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...Case Study 11 Karley Lapointe Liberty University Abstract C.W. is a patient with a gastrointestinal bleed that produced a duodenal ulcer. This ulcer then produced a bloody diarrhea stool. C.W. Was brought to the emergency room with by his wife for having bloody diarrhea for three days and was presenting signs of weakness and hypotension. C.W. underwent surgery for his gastrointestinal bleed and then was admitted to the hospital for having a fluid volume deficit, due to his diarrhea and bleed. C.W. being volume deficit made his fluid, electrolyte and blood levels become very abnormal. His medication that he was on for prior health history was causing some of his levels to rise and drop. He has a past medical history of cardiovascular problems, which were described and attributed to his current admitting problems. While at the hospital he went into sinus tachycardia and was placed on a Swan-Ganz catheter. One of the main goals for treating C.W. is to control his tachycardia and control his levels. He has some serious cardiovascular conditions that can not be healed but medical professionals, using education and medication , can better his quality of the life he has left. Patient C.W., a 70-year-old male, was admitted to the hospital at 0430 with a 25-X15-mm duodenal ulcer causing a gastrointestinal bleed, which was presented by “ dark red “ bloody diarrhea. His wife states that he has had diarrhea for 3 days with “dark red” stool starting the night before. She states that...
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