Gastric Ulcer

Gastric Ulcer

Gastric ulcers are open sores within the lining of the stomach. Stomach ulcers (gastric ulcers) are a type of peptic ulcer, meaning having to do with acid. Because of the amount of acid present in the stomach and the damage that can occur, they are often extremely painful. Although gastric ulcers can occur in any portion of the stomach, they are most commonly found on the lesser curvature close to the antral junction.

Definition

Gastric ulcer that develop inside the stomach.

Gastric ulcer occurs in the lesser curvature of the stomach to acid secreting parietal cell mass.

Causes

The most common cause of stomach ulcers is Helicobacter pylori, or H. pylori infection.

Ulcers may also be caused by overuse of painkillers, such as aspirin (Bayer), and other nonsteroidal anti-inflammatories (NSAIDs)

Risk Factors

·              Alcohol

·              Burns

·              Cigarette Smoking

·              Drug induced NSAID

·              Emotion / Stress

·              Family history

·              Gastritis

·              Hyperchlorohydria

·              Injection of toxins

Signs and Symptoms

·              Dull pain in the stomach

·              Weight loss

·              Not wanting to eat because of pain / Anorexia

·              Nausea or vomiting

·              Bloating

·              Feeling easily full

·              Burping or acid reflux

·              Heartburn (burning sensation in the chest)

·               Pain that may improve when you eat, drink, or take antacids

·               Anemia (symptoms can include tiredness, shortness of breath, or paler skin)

·               Dark, tarry stools

·               Vomit that’s bloody or looks like coffee grounds

Diagnosis

·              Barium Meal Study

·              Routine blood test

·              Oesophago Gastro Duodenoscopy (OGD) Ulcer appear with or without slough or bleeding in their typical locations.

·              Gastric secretary Studies.

·              Serology to test for H.pylori.

·              Breath test to detect H.pylori.

General Measures

·              Avoid use of NSAID drugs.

·              Avoid cigarette smoking.

·              Well balanced diet with meals at regular intervals.

Drug Therapy

·              Multiple drug regimens are used to treat H.Pylori.

Surgical Treatment: May perform in advanced disease condition

·               Billroth I Partial Gastrectomy with removal of antrum and pylorus of stomach.

·               Billroth II Gastrectomy: Here the gastrectomy is done below the ulcer and remant of the stomach is unastomosed to a jejunal loop.

Nursing Management

·              Take vital signs and BP.

·              Promote healthy life style.

Complications

•               Gastric Perforation, haematemesis, melaena

•               Gastric Outlet Obstruction (GOO)

•               GI haemorrhage