PUD, Stomach & Colorectal Cancer

• Peptic ulcer disease is erosion of the GI mucosa caused by H pylori, corticosteroids, anticoagulants, NSAIDs, and aspirin
• Two types of PUD

  • Gastric: it is superficial and the person has normal gastric secretion, has burning pain on the epigastrium and experiences pain 1-2 hours after meals
  • Duodenal: this is penetrating and the person has increased gastric secretion, burning pain on epigastrium and experiences pain 2-5 hours after meal. It is relieved by antacid or food
  • Both causes bloating, early satiety, weight loss, nausea and vomiting
• PUD is diagnosed through an endoscopy
• Drug Therapy

  • H2 blockers: Ex: cimetidine and PPIs Ex: pantoprazole
  • Both SE's are headache, nausea, vomiting and diarrhea
• other drug therapies include:

  • Antibiotics for at least 2 weeks
  • Cytoprotective drug: Ex: sucralfate
  • Give 1-2 hours before or after antacid
  • Antacid: Ex: calcium carbonate
  • Take 1-3 hours after meals or at bedtime
• PUD Complications

  • Hemorrhage
  • Gastric obstruction
  • Perforation: signs include sudden severe abdominal pain, rigid board-like abdomen, weak pulse. Treatment for this includes NPO, IVF, antibiotics and surgeyr
• Signs of stomach cancer include weight loss, pernicious anemia, dyspnea, indigestion and pain
• Patient may need TPN nutrition after stomach cancer surgery
• Signs of pernicious anemia include sore tongue, paresthesia and neuromuscular damage
• Treatment of pernicious anemia is cobalamin injection for life
• Colorectal cancer is cancer in the colon caused by bad diet, smoking or alcohol overconsumption
• Signs of colorectal cancer include ascites, abdominal pain, hematochezia, weight loss, diarrhea
• Care for Patients with Colorectal Cancer

  • Monitor electrolytes
  • Give IVF
  • Maintain NPO status
  • Check NGT every 4 hours