Peptic Ulcer Case Study

Being able to offer the highest quality of care to our patients involves understanding certain conditions that may cause a need to modify treatment. When treating a patient in the dental office that presents with peptic ulcers having an understanding about the disease can help you provide better care. This can be accomplished by having a understanding of what exactly a peptic ulcer is, etiological factors causing it, occurrence, physical characteristics and symptoms, medical management, oral characteristics observed and finally dental management and oral hygiene care.

First one must understand what exactly a peptic ulcer is. Peptic meaning, “a description relating to digestion in the upper digestive system (the stomach and small intestine)”
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Three main etiological factors cause the formation of peptic ulcers. The first and most important is due to a bacterial infection of Helictobacteria pylori. This bacteria damages the mucous lining causing weakness and allowing the acids through to the tissues below. The exact cause of how a patient becomes infected is unknown. The thought is it transmits through tainted water and food sources, unsanitary dining and transferring of bodily fluids. (Crowe and Peura, D, 2014) The next factor is the extended use of NSAIDs nonsteroidal anti-inflammatory drugs. Commonly used NSAIDs are aspirin and ibuprofen. NSAIDs work in the body by blocking enzymes in the body that help alleviate pain, fever and inflammation. Unfourtonelty, these enzymes also produce chemicals that help protect the lining so when blocks the enzymes from producing chemicals it then weakens the defenses of the lining allowing an ulcer to form. (Crowe and Peura, D, 2014) The last cause is not as common and is due to a tumor either cancerous or non-cancerous located in the stomach, pancreas or duodenum. (Crowe and Peura, D, 2014) Common belief was that stress and spicy foods caused peptic ulcers which is false, they make the ulcer worse but do not cause it. (Crowe and Peura, D, …show more content…
Peptic ulcers are able to be cured if treatment is completed properly. But there is a increased risk of developing a peptic ulcer again. First, you must identify the factor causing the ulcer. This is important due to the different treatments that may be necessary. The first tests and procedures are conducted to identify if the patient is infected by bacteria. Testing of the blood, stool or breath test to confirm or deny the presence of H. pylori. The breath test measures the amount of carbon dioxide in the breath. To accomplish this the patient will consume a drink containing urea, which if present the bacteria will convert into carbon dioxide. (Crowe and Peura, D, 2014) Another procedure is a Upper Gastrointestinal Endoscopy, this procedure is the most accurate. (Crowe and Peura, D, 2014) A special camera with a light called an endoscope is inserted through the oral cavity and down digestive tract. This camera is able to take photos and provide a live video. During the procedure small samples are collected from the lining of the stomach or duodenum. This is called a biopsy and can be examined to identify if there is the presence of H. pylori. The final procedure is Upper Gastrointestinal Series. In this procedure the patient is positioned in front of an x-ray machine while consuming liquid called barium. This liquid will line the tract allowing doctors to identify ulcers. (Crowe and Peura, D, 2014) This particular test is not used when diagnosing the

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