PUD Flashcards
Paracentesis to manage ascites
Erosion of GI mucosa 2nd to digestive actions of HCL and pepsin- avoid acidic envir.
Types of PUD
Acute
Chronic
Gastric
Duodenal
Acute PUD
Short duration w superficial erosion, minimal inflammation
Chronic PUD
long duration, erosion through muscular wall and fibrosis (common than acute)
Gastric PUD
- More common in antrum, more prevalent in women/elderly. Peak over 50 yo
Risk factors of gastric PUD
H pylori, meds, smoking bile reflux
Pain associated with gastric PUD
High epigastric region
1-2 hrs after meals
burning/gas
if related to erosion, food aggravates pain
Duodenal PUD
80% of all PUD, associated w high HCL, any age, most common 35-45 yo,
Risk factors of duodenal PUD
90-95% h pylori!
Pain associated with duodenal PUD
Mid epigastric region- back pain w posterior duodenum
2-5hrs after meals- Food acts as buffer
Burning/Cramping
Relieved w antacids or h2r blocker
Occurs continuous for weeks/months than disappears for a few months
Complications of PUD
Hemmorrhage
Perforation
Gastric outlet obstruction
Hemorrhage with PUD
Most common complication
Duodenal ulcers account for greater % of UGI bleed than gastric ulcers
Perforation with PUD
Most lethal- sudden severe abd pain
Erosion allows gastric contents to empty into peritoneal cavity
BS absent, Respirations
Gastric outlet obstruction with PUD
Narrowing of pylorus
Inflammation, edema, pylorospasm, fibrous scar tissue
Interventions for PUD
Labs- CBC, Lytes, Liver enzymes, UA, H. pylori
Rest- Physical & Emotional
Dietary modifications- Bland diet, 6 small meals/day No ETOH, No caffeine
Drug therapy -Antacids, H2R blockers, PPI, antibiotics (+ H. pylori)
Eliminate smoking!
