PEPTIC ULCER DISEASE (PUD)

Question 1

Erosion in stomach, esophagus or duodenum. Duodenal ulcers are more common than gastric ones, but gastric take longer to heal.

Answer 1

PUD

Question 2

PUD is commonly caused by

Answer 2

H. Pylori infection

Question 3

What type of ulcer?

Pain 3-60 mins after meal
Less often pain at night
Pain exacerbated by ingestion of food
Malnourishment
Hematemesis

Answer 3

Gastric ulcer

Question 4

What type of ulcer?

Pain 1.5 - 3-4 hrs after meal
Awakening with pain at night
Pain relieved by food or antacids
Well nourished
Melena

Answer 4

Duodenal ulcer

Question 5

What type of medication is a risk factor for PUD?

Answer 5

NASIDs

Question 6

What meds can be used for PUD?

Answer 6

-Antibiotics
-H2 receptor antagonists
-PPI
-Antacids
-Mucosal protectants
-Sucralfate
-Prokinetics (Misoprostol)

Question 7

Labs & diagnostics for PUD

Answer 7

H Pylori test
Urea breath test
Stool sample for H pylori antigen
H&H
Stool sample for Guaiac
EGD

Question 8

Complications of PUD

Answer 8

-Perforation/hemorrhage- tender and rigid abdomen
-Pernicious anemia
-Dumping Syndrome
-Pyloric obstruction

Question 9

Shift of fluids to the abdomen triggered by rapid gastric emptying

Answer 9

Dumping Syndrome

Question 10

Manifestations of dumping syndrome

Answer 10

-Diarrhea
-Vasomotor symptoms 10-90 mins after meal (pallor, perspiration, palpitations, headache, feeling of warmth, dizziness)

Question 11

Pt education for PUD

Answer 11

Avoid smoking, NSAIDS, triggers, and alcohol.

Take your med regularly NOT intermittently!

Drinking milk is a MYTH! Milk increases acid production in the stomach.