Peptic Ulcer disease icd 10 Types Tretment


Peptic Ulcer Introduction

  • Peptic refers to a pepsin.
  • Pepsin is a stomach enzyme that breaks down into protein.
  • Pepsinogen enzyme is released from the chief cell of the stomach.
  • Parietal cells of the stomach release HCL and intrinsic factors.

Peptic Ulcer Definition

  • A peptic ulcer is a gastrointestinal disorder in which a lesson in the lining oesophagus, stomach and duodenum. Peptic ulcer is an ulcer lesion of GI tract.

Types of ulcer

  1. Gastric ulcer
  2. Duodenal ulcer
  3. Oesophageal ulcer.
  1. Gastric ulcer

it is a lesion of mucous membrane of stomach due to ingestion of alcohol, caffeine, aspirin, NSAID drugs etc.

  • Pain occurs 1-2 hours after a meal.
  • Pain relief after vomiting.
  • Gastric ulcers usually occur on the lesser curvature of the stomach.
  • Epigastric abdominal pain.
  • Gastric ulcers commonly occur in older people.
  • Gastric ulcer commonly in females.
  1. Duodenal ulcer – 

It is lesion of mucous membrane of duodenum.

  •  Burning right epigastric pain occurs.
  • Pain occurs 2-4 hours after meals.
  • Pain relief after food consumption.
  • Duodenal ulcer most commonly occurs in young adults.
  • Duodenal ulcer causes a very low risk of malignancy.
  1. Oesophageal ulcer 

Ulcer lesion in mucosa of oesophagus.

  • Occur due to hydrochloric acid in oesophagus.
  • Mostly the lower part of the oesophagus is affected.

Cause of peptic ulcer

  • Infection by bacteria ( H. Pylori )
  • Use of NSAID.
  • Genetic disorder.
  • Prolonged excessive emotional and stress situation.
  • Excessive intake of alcohol and Caffeine.
  • Smoking, coffee, tea.
  • Gastritis.
  • Fasting.
  • Hypercalcemia.
  • Diet.

Pathophysiology of Peptic Ulcer

Cause/risk factor / H- pylori bacteria

Excessive secretion of HCL and decrease mucus secretion

Irritate mucous membrane of GI tract

The lesion in the GI tract

Peptic ulcer.

Signs and symptoms of Peptic Ulcer

  1. Gastric ulcer

  • Pain in the left epigastric region.
  • Weight loss
  • Burning sensation pain
  • Nausea vomiting
  • Haemoptysis ( blood in vomiting )
  • Anorexia
  • Heartburn
  • Malnourished
  • Projectile vomiting.
  1. Duodenal ulcer

  • Pain in right epigastric region
  • Abdominal discomfort
  • Malana
  • Weight gain
  • Well nourish
  • Dyspepsia ( indigestion )
  • Nausea and vomiting.

Peptic ulcer lab investigation

  • History collection and physical examination.
  • Stool examination.
  • Barium meal x-ray.
  • Endoscopic examination.
  • Gastric analysis.
  • CBC and haemoglobin test.
  • History and screening of gastric carcinoma.
  • Urea breathe test.

Treatment of Peptic Ulcer

  • Antacid
  • Antimicrobial drug
  • H2 blockers
  • Proton pump inhibitors
  • Mucosal protective agents
  • IV fluid
  • Nasogastric tube administer
  • Antibiotics for H. Pylori
  • NPO
  • Hyper secretory drug therapy.

Peptic ulcer surgery  

  • Vagotomy – cut the vagus nerve.
  • Total gastrectomy – remove stomach.
  • Pyloroplasty – help to widen the pylorus.
  • Billroth 1 – partial gastrectomy with permanent gastroduodenostomy.
  • Billroth 2 – partial gastrectomy with permanent gastrojejunostomy.
  • Gastric reaction.

Peptic ulcer diet plan  

  • Encourage more fluid.
  • Avoid – spicy food
  • Alcohol, smoking, caffeine
  • Oily food
  • Tea, coffee
  • Provide small frequent food.
  • High vitamin B12 diets.

Complications of peptic ulcer  

  • Dumping syndrome.
  • Vitamin B12 deficiency.

Nursing management of Peptic Ulcer

  • Nurses determine the patient’s condition and assess vital signs.
  • Determine the severity and intensity of pain.
  • Assess risk factors about smoking, alcohol, NSAID, drugs.
  • Prepare antibiotics for treating H. Pylori infection.
  • Nurses avoid aspirin, NSAID, coffee, tea etc.
  • Nurses educate about refusing high spicy junk foods.
  • Monitor hematemesis and melena.
  • Examine the diagnostic procedure and identify which type of ulcer.
  • Provide stool softener medication.

Key Points

  1. An ulceration lesions in GI tract is called – Peptic ulcer.
  2. The most common cause of peptic ulcer – H. Pylori.
  3. A common peptic ulcer is – Duodenal ulcer.
  4. A common symptom of peptic ulcer – Projectile vomiting.
  5. Which type of peptic ulcer in older people – Gastric ulcer.
  6. Which type of ulcer in young people – Duodenal ulcer.
  7. Common diagnostic test of peptic ulcer – Endoscopic examination.
  8. The common complication of peptic ulcer – Dumping syndrome.
  9. Weight loss situation arises in which type of peptic ulcer – Gastric ulcer.
  10. H. Pylori bacteria detect by – Urea breathe test.
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