PEPTIC ULCER

 Ulcer that occurs in the esophagus, stomach or duodenum within the upper
gastrointestinal tract.
 Occur when there is hyper secretion of HCL acid and pepsin which erode the
GI mucosal lining.

2 SPHINCTER MUSCLES

1. Cardiac
2. Pyloric

ESOPHAGEAL ULCER

 Result from reflux of acid gastric secretions into the esophagus as a result of
defective or incompetent cardiac sphincter

GASTRIC ULCER

 Occurs because of a breakdown of GMB (Gastric mucosal barrier)

DUODENAL ULCER

 Caused by hypersecretion of acid for the stomach passing into the duodenum
because of:
1. Insufficient barriers to neutralize gastric acid in the stomach.
2. Defective with incompetent pyloric sphincter.
3. Hyper motility of the stomach.

GERD

 Gastro esophageal reflux disease.

 Inflammation or erosion of the esophageal mucosa caused by reflux of
gastric acid content from the stomach into the esophagus.

ANTI ULCER AGENTS

1. Tranquilizers
2. Anti-cholinergic
3. Histamine (H2) blocker
4. Protein pump inhibitors
5. Antacids
6. Prostaglandin
7. Pepsin Inhibitor

2 TYPES OF ANTACIDS

1. SYTEMIC
a. Sodium bicarbonate
 Systematically absorbed antacid
 One of the first anti-ulcer drugs
b. Calcium Carbonate
2. NON-SYSTEMIC
 Composed of alkaline salts such as aluminum hydroxide, aluminum
carbonate, magnesium hydroxide, magnesium carbonate, magnesium
insilicate, magnesium phosphate.

 The ideal dosing internal for antacids is 1-3 hrs. after meals (Maximum acid
secretions occurs after eating and at bedtime)
 Antacid containing magnesium salts are contraindicated in clients with
impaired renal function.

HELICOBACTER PYLORI

 Gray - bacillus linked with develop peptic ulcer.

URETER UBT (Urea breath test)

 Noninvasive – breathe test to detect H-PYLORI.

TRIPLE THERAPHY TREATMENT

 Metronidazole (AMOXICILLIN)
 Omeprazole (LANSOPRAZOLE) and Clarithromycin

QUADRUPLE THERAPHY

 2 Antibiotics, A PPI, Bismuth or Histamine blocker.