Definition of Peptic Ulcer
Peptic ulcer ek open sore (ghav) hota hai jo stomach, duodenum ya rarely esophagus ke mucosal lining me develop hota hai due to acid and pepsin erosion.
Ye condition tab hoti hai jab protective mucus layer kam ho jati hai aur acid lining ko damage karta hai.
Types of Peptic Ulcer
2. Duodenal Ulcer – Duodenum (small intestine ka first part) me banta hai.
Causes of Peptic Ulcer
● Helicobacter pylori (H. pylori) infection – most common cause.
● Excess use of NSAIDs (Aspirin, Ibuprofen).
● Excess stomach acid production (Zollinger-Ellison syndrome).
● Stress and smoking.
● Alcohol consumption.
● Caffeine and spicy food.
● Family history of ulcers.
Risk Factors of Peptic Ulcer
● Age above 50 years.
● Chronic stress.
● Regular painkiller use.
● Heavy smoking or alcohol intake.
● Previous ulcer history.
● Unhealthy diet habits.
Pathophysiology of Peptic Ulcer
● Normally, stomach mucosa protected hoti hai mucus & bicarbonate se.
Jab acid production badh jata hai ya protection kam ho jati hai, tab acid directly mucosa ko damage karta hai.
● Mucosal injury → Inflammation → Ulcer formation.
● Ulcer deepen hone par bleeding ya perforation ho sakta hai.
Clinical Manifestations of Peptic Ulcer
● Burning or gnawing pain in upper abdomen.
● Pain after eating (gastric ulcer) or before meals (duodenal ulcer).
● Nausea, vomiting, bloating.
● Loss of appetite and weight loss.
● Dark or tarry stool (melena).
● Hematemesis (vomiting blood).
● In severe cases: perforation or peritonitis symptoms (severe pain, rigidity).
Complications of Peptic Ulcer
● Bleeding ulcer (most common).
● Perforation → hole in stomach/duodenum.
● Peritonitis (infection in abdominal cavity).
● Gastric outlet obstruction (narrowing due to swelling).
● Anemia due to blood loss.
Diagnosis of Peptic Ulcer
● Endoscopy (Gastroscopy): Confirm ulcer and biopsy for H. pylori.
● H. pylori test: Urea breath test, stool antigen, or biopsy.
● Barium meal X-ray: Outline of ulcer.
● CBC: Check for anemia.
● Occult blood test: Detect hidden bleeding.
Treatment of Peptic Ulcer
1. Medical Management
● Antibiotics: Amoxicillin, Clarithromycin, Metronidazole (for H. pylori).
● Proton Pump Inhibitors (PPIs): Omeprazole, Pantoprazole (reduce acid).
● H2 blockers: Ranitidine, Famotidine.
● Antacids: Neutralize acid.
● Cytoprotective agents: Sucralfate, Misoprostol (protect mucosa).
2. Surgical Management
(Only if medical treatment fails or complications occur)
● Vagotomy: Cut vagus nerve to reduce acid.
● Partial gastrectomy: Remove part of stomach.
● Pyloroplasty: Enlarge pyloric opening for drainage.
Nursing Management of Peptic Ulcer
● Assess pain, nausea, vomiting pattern.
● Encourage small, frequent meals.
● Avoid spicy, oily, acidic food.
● Avoid smoking, alcohol, caffeine.
● Administer medications on time (especially PPIs before meals).
● Monitor for bleeding (black stool, vomiting blood).
● Provide emotional support and health education.
Prevention of Peptic Ulcer
● Wash hands properly to prevent H. pylori infection.
● Avoid self-medication with painkillers.
● Eat balanced diet and manage stress.
● Avoid alcohol and tobacco.
● Regular medical checkup if symptoms persist.
Summary of Peptic Ulcer By NurseLogy
● Peptic ulcer disease ek painful gastric condition hai jisme acid and pepsin mucosal lining ko damage karte hain.
● Main causes H. pylori infection aur NSAID use hain. Early diagnosis, lifestyle modification, aur acid suppression therapy se cure possible hai.
● Agar untreated raha to bleeding, perforation aur peritonitis jaise complications ho sakte hain.
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