Gastroduodenal Ulcers (PUD)

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This is a disorder resulting from breakdown of mucosal defense mechanisms against hydrochloric  acid and proteolytic enzymes, most commonly secondary to H. Pylori infection or NSAID use. 

Clinical presentation 

  • Burning epigastric abdominal pains, usually relived by antacids.
  • Anorexia, early satiety, bloating,
  • Hematemesis or melena stools
  • Weight loss

Investigations 

  • Endoscopic evidence of gastric or duodenal mucosal ulceration

Pharmacological Treatment 

A: omeprazole (PO) 20mg 24hourly for 8weeks 

OR 

C: pantoprazole (PO) 40mg 24hourly for 8weeks 

OR 

S: esomeprazole (PO) 20mg 24hourly for 8weeks 

AND  

A: antiacid liquid (PO) 10-15ml 12hourly to 8hourly for 7-14days 

For bleeding PUD: refer to higher centers 

C: pantoprazole (IV) 80mg stat then 40mg 12hourly for 2-3days, then (PO) as above if 

bleeding stops 

OR 

S: esomeprazole (IV) 40mg 12hourly for 2-3days, then (PO) as above if bleeding stops