This document discusses the presentation and management of stomach ulcers. It begins with an introduction defining stomach ulcers and their prevalence. It then covers the classification, etiology, clinical manifestations, diagnostic assessment, and treatment options for ulcers. Treatment includes pharmacological therapy with triple therapy consisting of antibiotics, proton pump inhibitors, and bismuth salicylates. Dietary modifications, stress reduction, and smoking cessation are also reviewed as part of medical management. Surgical options like pyloroplasty, vagotomy, and Billroth procedures are presented if medical management fails. Key questions are provided at the end to test understanding.

1. ADESHWAR NURSING
INSTITUTE JAGDALPUR
MEDICAL SURGICAL NURSING
CLASS TEACHING
PRESENTED BY: -
Miss. Priya Vishwakarma
M. Sc Nursing First Year

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3. NORMAL STRUCTURE OF
STOMACH

4. INTRODUCTION
• Stomach ulcers, also known as gastric ulcers, are open
sores that develop on the lining of the stomach.
• Ulcers can also occur in part of the intestine just beyond
the stomach (duodenum).
• Stomach ulcers can affect people of any age, including
children, but mostly occur in people aged 60 or over.
• Men are more commonly affected than women.

5. CLASSIFICATION
PEPTIC
ULCER
GASTRIC
ULCER

6. CLASSIFICATION

7. ETIOLOGY

8. ETIOLOGY

9. ETIOLOGY

10. ETIOLOGY

12. CLINICAL MANIFESTATIONS

13. CLINICAL MANIFESTATIONS

14. CLINICAL MANIFESTATIONS

16. ASSESSMENT AND DIAGNOSTIC
FINDINGS

17. ASSESSMENT AND DIAGNOSTIC
FINDINGS

18. ASSESSMENT AND DIAGNOSTIC
FINDINGS

19. MEDICAL MANAGEMENT
PHARMACOLOGICAL THERAPY
(TRIPLE THERAPY)
ANTIBIOTICS (Amoxicillin, Clarithromycin) +
PROTON PUMP INHIBITORS (Omeprazole,
Lansoprazole) + BISMUTH SALICYLATES

20. TRIPLE THERAPY
Clarithr
omycin
500mg
Omepra
zole
20mg
Amoxici
llin
1000 mg
10
days

21. AMOXICILLIN
MECHANISM OF ACTION
Inhibition of cell wall synthesis
Death of bacteria
SIDE EFFECTS
• Diarrhea
• Headache
• Taste perversion

22. OMEPRAZOLE
MECHANISM OF ACTION
Blocks H/K/ATPase of parietal
cells
Inhibit secretion of gastric acid
SIDE EFFECTS
• Diarrhea
• Headache
• Nausea and vomiting

23. BISMUTH SALICYLATES
MECHANISM OF ACTION
Inhibition of prostaglandin
synthase
Inflammation of stomach &
intestinal lining
SIDE EFFECTS
• Abdominal pain
• Anal discomfort
• Black/ hairy tongue
• Tarry/ clay colored stool

24. MEDICAL MANAGEMENT
STRESS REDUCTION AND REST

25. MEDICAL MANAGEMENT
SMOKING CESSATION

26. MEDICAL MANAGEMENT
DIETARY MODIFICATION

27. DIETARY MODIFICATION

28. SURGICAL MANAGEMENT
PYLOROPLASTY

29. VAGOTOMY

30. BILLROTH PROCEDURE

31. SUMMARY

32. ANSWER THE QUESTIONS
Q. What is best used for detecting small or healing
ulcers?
a) Endoscopy
b) Barium radiography
c) Urea breath test
d) Abdominal CT.

33. Q. Complications of PUD include bleeding,
perforation, and penetration. Bleeding typically
manifests as_________
a)Melena
b)Clots
c)Coffee ground
d)Loose runny stools

34. Q. What often describes the pain of PUD?
a) Sharp, knife-like, radiates to right shoulder
b) Dull,achy, localized to stomach
c) Diffuse, joint arthritis
d) Burning, gnawing, radiates to the back

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