Understanding Gastritis and Peptic Ulcer Disease

May 7, 2024

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Lecture Notes on Gastritis and Peptic Ulcer Disease (PUD)

Summary

In this lecture, we covered the fundamental concepts of gastritis and peptic ulcer disease (PUD), including their risk factors, symptoms, diagnosis, and treatment options. There was a focus on the significant role of Helicobacter pylori infection in both conditions. The session concluded with a quiz to test the understanding of the key points discussed.

Gastritis

  • Definition: Inflammation of the gastric mucosa.
  • Risk Factors:
    • Helicobacter pylori infection
    • Long-term NSAID use
    • Smoking
    • Stress
    • Heavy alcohol use
  • Symptoms:
    • Dyspepsia (heartburn or indigestion)
    • Nausea and vomiting
    • Stomach pain
    • Bloating
    • Lack of appetite
  • Severe Symptoms:
    • Formation of ulcers which can bleed and cause anemia
  • Diagnostic Tools:
    • Endoscopy-Guided-Diagnostic (EGD)
    • Upper GI series
    • Fecal occult blood test (to detect blood in stool)
    • Urea breath test (to detect H. pylori)
  • Treatment:
    • Lifestyle modifications (avoid alcohol, quit smoking, reduce stress)
    • Medications: Proton Pump Inhibitors (PPIs), H2 antagonists, antacids
    • Antibiotics for H. pylori infection

Peptic Ulcer Disease (PUD)

  • Definition: Erosion in the mucosa of the stomach, esophagus, or duodenum.
  • Key Risk Factor:
    • H. pylori infection
  • Other Risk Factors:
    • Chronic NSAID use
    • Corticosteroids
  • Symptoms:
    • Epigastric pain
    • Nausea and vomiting
    • Bloating
    • Hematemesis (bloody vomit)
    • Melena (bloody stools)
  • Pain Characteristics:
    • Gastric Ulcer: Pain 15-30 minutes after eating, worse during the day and with food.
    • Duodenal Ulcer: Pain 2-3 hours after eating, worse at night, improves with food.
  • Diagnosis:
    • Gold standard: Esophagogastroduodenoscopy (EGD)
  • Treatment:
    • Multiple antibiotics for H. pylori to prevent resistance
    • Medications: H2 blockers, PPIs, antacids, sucralfate
  • Patient Teaching:
    • Avoid NSAIDs, caffeine, smoking, and alcohol.
  • Complications:
    • Hypovolemic shock (due to extensive bleeding)
    • Perforation leading to peritonitis requiring emergency surgery

Quiz for Review

  1. What type of bacterial infection causes gastritis and PUD?
    • Answer: H. pylori infection.
  2. Symptoms related to ulcer types:
    • Pain 2-3 hours after a meal (Duodenal Ulcer)
    • Decreased pain with eating (Duodenal Ulcer)
    • Pain worse in daytime (Gastric Ulcer)
  3. What complication can cause severe pain and a rigid board-like abdomen?
    • Answer: Perforation leading to peritonitis.

These notes follow the lecture closely, detailing the essential points for understanding gastritis and PUD, which are vital for nursing students and practitioners in the medical-surgical field.