Peptic Ulcer DISEASE/GASTRITIS

Clinical Description

Commonly caused by Helicobacter pylori.

Other risk factors: NSAIDs chronic use, alcohol, smoking

Non-pharmacological

• Avoid spicy foods
• Avoid alcohol and tobacco intake
• Avoid foods that aggravate pain
• Avoid or reduce on fizzy drinks

Pharmacological

Treatment (Triple Therapy):

• Omeprazole 40mg 24 hourly for 2 weeks
• Metronidazole 400mg 8 hourly for 2 weeks
• GiveAmoxycillin1g12 hourlyfor 2 weeks

Alternatively:

• Omeprazole 20 mg 12 hourly for 2weeks
• Metronidazole 400mg 8 hourly for 2 weeks
• Give Clarithromycin 500mg 12 hourly for 2 weeks

Red Flag:

• Refer for endoscopy and further management if ongoing pain and alarm

Signs and Symptoms

• weight loss, haematemesis, melaena, anaemia, dysphagia, recent progressive symptoms, age > 16 years.

Aspirin and other non-steroidal anti- inflammatory drugs (NSAIDS) e.g. Indomethacin, Ibuprofen, diclofenac are contraindicated in patients with a history of peptic ulcer disease.