Disorders of the Gastrointestinal System, 2nd Edition
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Peptic ulcers Peptic ulcer disease (PUD) is an erosion of the GI mucosa (Vakil, 2022). Peptic ul- cers are circumscribed lesions that can develop in the lower esophagus, stom- ach, pylorus (the area of the stomach that connects to the small intestine), duode- num, the jejunum (the portion of the small intestine that is located between the du- odenum), or the ileum (the lowest portion of the small intestine that connects to the large intestine; Anand, 2021). Figure 7. Gastric Ulcer
ive measures include the administration of analgesics, blood transfusion if indicat- ed, and close assessment of intake and output (Daley, 2019). Surgery must be performed as soon as possible if perito- nitis is caused by a perforated fallopian tube or ruptured diverticula. The aim of surgery is to remove the contents spilled into the peritoneum from the perforation and prevent additional organ and tissue damage (Daley, 2019). CASE STUDY 6 Angela is a 55-year-old breast cancer survivor. She is self-employed as a man- agement consultant. Her job is stressful, and she smokes about a pack of ciga- rettes daily. Angela has been experienc- ing heartburn and indigestion for several months, particularly after meals. She also notices that the discomfort intensifies af - ter drinking orange juice or coffee. She attributes these symptoms to job stress and is self-medicating with antacids. Be- cause of her previous cancer diagnosis, she becomes concerned and seeks med- ical help. Her physician ordered an upper GI and small bowel series. The physician sus- pects that Angela may have a peptic ul- cer. Question Which of the following is a risk factor for developing a peptic ulcer? a. Spicy food. b. Stress. c. H. Pylori infection. d. High-fat diet. Answer/Rationale: The correct answer is c. Peptic ulcers are most often found in those who are H. pylori– positive or chronic users of NSAIDs.
Note . BruceBlaus. (2015). Gastric Ulcer. https://commons. wikimedia.org/w/index.php?curid=44923645. CC BY-SA 4.0. Peptic ulcers can have serious, even fa- tal, consequences. In the U.S., the mor- tality rate from an ulcer complication is 5%, and the mortality rate from a related emergency surgery is between 6% and 30%. Obstruction, perforation, and bleed- ing are the most common complications contributing to this mortality rate (Anand, 2021). Peptic ulcers were previously more frequently diagnosed in males, but now a similar diagnosis rate exists between males and females. They are most often found in those who are H. pylori–positive or chronic users of NSAIDs (Anand, 2021).
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