Download Peptic Ulcer Disease

Chapter 8
Drugs for
Gastrointestinal
Disorders
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Gastrointestinal (GI)
Disorders
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Peptic ulcer disease
Gastroesophageal reflux disease
Diarrhea
Constipation
Intestinal gas
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Peptic Ulcer Disease (PUD)
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Mucosa erosion – stomach or duodenum
Often asymptomatic
Damage from
– Alcohol abuse
– Cigarette smoking
– NSAIDs
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Signs and symptoms of
PUD
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Dull stomach ache
Poor appetite
Bloating
Burping
Nausea
Vomiting
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Treatment Options for
PUD
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Directed towards relieving pain, accelerating
ulcer healing, and minimizing recurrence
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H2 receptor antagonists (Tagamet, Zantac)
Proton pump inhibitors (Prilosec, Prevacid)
Antacids (Tums, Rolaids)
Sucralfate (prescription only)
Bismuth compounds (Pepto-Bismol)
Antibiotics
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Adverse Effects
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Diarrhea
Constipation
Headache
Stomach cramps
Dizziness
Rash
Nausea
Vomiting
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Gastroesophageal Reflux
Disease (GERD)
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Movement of gastric contents into the
esophagus
Lower esophageal sphincter (LES)
does not close properly
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GERD (cont.)
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Possible problems with GERD
– Esophageal strictures (narrowing or
constriction)
– Esophageal ulcers
– Perforations
– Hemorrhage
– Aspiration
– Motility disorders
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Heartburn
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Most common symptom of GERD
Pain in center of chest
Most do not seek treatment right away
Aggravated by
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Foods high in fat
Spices, onions, citric juices, coffee (caffeine)
Alcohol
Body position
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Treatment and Adverse
Effects
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Goals of treatment
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Eliminate symptoms
Limit frequency and duration
Promote healing
Prevent complications
Alter factors that cause reflux
– Lose weight, proper diet
– Loose-fitting clothes
– Limit smoking, alcohol, laying down after eating
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Antacids
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Relieve mild to moderate symptoms
– Decrease gastric acidity
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Rapid onset, short duration
Taken with food = last up to 3 hours
Adverse effects
– Diarrhea
– Constipation
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Table 8-2: Antacid
Classifications*
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Diarrhea
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Genetic Disorder
Abnormal frequency and liquidity of
fecal discharge
Origin
– Infection (Salmonella)
– Toxic
– Drug-induced
– Diet
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Acute or Chronic
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Acute (sudden onset)
– Food induced (traveler’s)
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Chronic (2 weeks or longer)
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Stress or Irritable bowel syndrome
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Treatment and Adverse
Effects
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Goals of treatment
– Control the loss of fluids (athletes)
– Identify and treat cause
– Provide symptomatic relief
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Refer to physician if
– Persists for several days
– Blood in stool
– Severe abdominal pain, cramps
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If from a bacterial infection – do not
stop movement
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Antiperistaltic agents (Imodium)
– Dizziness, dry mouth , rash
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Bismuths (Pepto-Bismol)
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Figure 8-1, pg 111
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Constipation
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Decrease in the frequency of fecal
elimination (hard/dry stool)
Diet low in fiber
Lack of exercise
Insufficient fluid intake
Excessive intake of foods
Resisting defecation impulses
Diabetes, pregnancy
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Antidiarrheal medications
– Can cause constipation
– Low back pain, headache, distension,
abdominal pain
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Treatment
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Increase fiber intake
– Bulk-forming laxatives
– FiberCon, Metamucil
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Increase fluid intake
Aerobic exercise
Stimulant laxatives
– Dulcolax
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Saline salt laxatives
– Phillips’ Milk of Magnesia/Fleet enema
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Implications for athletes, pg 113
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Intestinal Gas
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Belching, abdominal discomfort,
bloating, flatulence
Results from malabsorption of
carbohydrates and proteins
– Fruits, vegetables, lactose
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Simethicone (Gas-X)
Alpha-galactoside (Beano)
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Athletic Trainer’s
Responsibility
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Recognize and refer
Trusting relationship
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