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Peptic Ulcer

An erosion in the stomach or duodenal lining

Definition

A peptic ulcer is a sore in the lining of the stomach (gastric ulcer) or duodenum (duodenal ulcer) caused by imbalance of acid/pepsin and mucosal defenses.

Causes

  • Helicobacter pylori infection (most common)
  • NSAIDs and aspirin
  • Stress ulcers (Curling's/Cushing's)
  • Zollinger-Ellison syndrome (gastrinoma)
  • Smoking, alcohol

Gastric vs Duodenal

  • Gastric: Pain WORSE with food, weight loss, higher malignancy risk.
  • Duodenal: Pain RELIEVED by food, night waking; weight gain.

Complications

Bleeding (hematemesis, melena), perforation (sudden severe pain, rigid abdomen), obstruction.

Nursing Interventions

Treat H. pylori with triple therapy (PPI + clarithromycin + amoxicillin/metronidazole × 10 to 14 days). Administer PPIs (omeprazole), H2 blockers, sucralfate. Avoid NSAIDs, aspirin, alcohol, smoking, spicy foods. Monitor for bleeding.

NCLEX Relevance

Gastric: pain WITH food. Duodenal: pain RELIEVED by food.