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Home , Diarrhea, Nausea, Peptic ulcer disease

An Academic Research Center of Excellence #!"" AWARE SEPTEMBER ! OCTOBER : Feel the

2010 peptic (derived from the word bacterium known as pylori pepsin, an in the (H. pylori). The association between this A that helps digest protein) ulcer is organism and ulcer disease was !rst made THE CENTER FOR PHARMACY CARE de!ned as an erosion in the lining of the by Marshall and Warren in the early 1980’s 1000 Fifth Avenue, Muldoon Building stomach, the !rst part of the and they were recognized in 2005 by being (also known as the ), or awarded the Nobel Prize in Medicine. Monday – Friday 9:00 a.m. to 4:00 p.m. that results in the development of an open H. pylori resides within the mucous layer lesion. The majority of peptic occur that protects tissues lining the stomach and Complimentary Screenings and Services in the duodenum. Nearly 10% of Americans small intestine. Although it may be found will su"er from a peptic ulcer at some point • Bone density in nearly 50% of all individuals, H. pylori in their lives. Many individuals mistakenly typically does not result in gastric symptoms. • Body composition analysis believe these ulcers are caused be lifestyle It can, however, disrupt the mucous layer factors such as or eating spicy . resulting in irritation and ulceration. • Facial skin analysis In reality, most peptic ulcers are caused Peptic ulcers may also be associated with the by the presence of a speci!c bacterium • Serum glucose and A1C testing for diabetes regular use of nonsteroidal anti-in#ammatory or . Today, most ulcers can be drugs (NSAIDs) such as and • Cholesterol screening prevented or treated using a variety of (Advil). Smoking and excessive consumption appropriate therapies. • Tobacco cessation program of may also result in ulcer formation. • Health care coaching Although stress itself is not considered a !"#$%&#! primary of peptic ulcers, it can result in • therapy management Small ulcers typically go unnoticed because their delayed healing. they rarely produce symptoms such as • screening or abdominal discomfort. However, some +,(-.&!,! ulcers may result in serious or even Please call for an appointment, x2155 If you suspect you may be su"ering from perforation, thus their severity must not be a peptic ulcer, contact your physician. As underestimated. An ulcer can be de!ned discussed earlier, long-standing symptoms as a hole or tear in the wall of the stomach. may be related to other , including The hallmark symptom of ulcer disease is a cancer. This is the major reason the maximum burning or gnawing sensation that produces recommended duration for treatment of . Other common symptoms abdominal pain with many over-the-counter include , and . Those preparations is only fourteen days. Your with a family history of ulcers, individuals 50 doctor will most likely ask you a number of years of age and older and those su"ering from questions including when you !rst began to , kidney or lung disease are more likely to experience discomfort and whether there develop this condition. was anything that routinely improved or Pain associated with ulcers is produced by worsened your symptoms. Prior to seeing the local e"ects of stomach on the the physician, make a list of all prescription Blood Pressure Screening open or in#amed lesion. The pain frequently and non-prescription drugs and dietary • September 13, 20 & 27, noon-2 p.m. occurs during the night and becomes worse supplements you are currently taking. when the stomach is empty. Pain can be • October 4, 11, 18 & 25, noon-2 p.m. You may require some diagnostic tests to temporarily relieved by eating foods that determine the actual presence and location Forbes Lobby, Power Center serve to bu"er the stomach acid or by taking of an ulcer. The procedure of choice for No appointment necessary medications that reduce acid production. most physicians is known as . Over-the-counter and acid blockers You will be mildly sedated and the doctor Tanita Screening may o"er short-term relief; however, will use an instrument known as an • September 17 & 24, noon.-2 p.m. prolonged ulcer-type pain MUST be brought to the attention of a physician. endoscope. This tube-like device permits • October 1, 8, 15, 22 & 29, noon.-2 p.m. the gastroenterologist to actually view the nd 2 Floor, Power Center '()!*! esophagus, stomach and upper part of the No appointment necessary small intestine. If an ulcer or other lesion is Most cases of are detected, your doctor may elect to remove considered to be due to the e"ects of a continued PEPTIC ULCER DISEASE: Feel the Burn

a small section of tissue and perform a prescribed period of time. Failure to do so like aspirin, ibuprofen or other NSAIDS for . This is an important step because it may lead to incomplete elimination of the prolonged periods of time. Acetaminophen allows the physician to rule out more serious and continued progression of your (Tylenol, etc.) is an e"ective and not conditions including cancer. condition. usually associated with ulcer disease. If you Sometimes ulcers fail to heal even when have any questions about what you should %/*(%#*.% you are taking medications. Reasons include be taking for pain management, speak with Once the presence of an ulcer has been not taking the medication according to your doctor or pharmacist. Patients who established, physicians typically use two directions, use of alcohol and tobacco, smoke, chew tobacco and/or alcoholic di"erent methods for treating the condition. resistance of H. pylori to the and beverages increase their risk of developing If present, many physicians eliminate H. continued use of NSAIDs. an ulcer. pylori by prescribing various combinations of Everyone must be aware of the warning signs antibiotics. These include medications such 01(%2"&)2'(.2+& and symptoms of ulcer disease and seek as (Amoxil, etc.), You can take steps to prevent the medical attention when they become severe (Biaxin, etc.) and (Flagyl). In development of ulcers. Although NSAIDS and/or chronic. When in doubt, it is always general, the antibiotics will be prescribed are e"ective in reducing pain, excessive preferable to speak with your physician. In for periods ranging from 10-14 days. use of these medications can lead to ulcer the case of peptic ulcers, it is better to be safe The antibiotics will also be prescribed in formation. If possible, avoid using drugs than sorry. combination with drugs known as proton- pump inhibitors (PPIs). These drugs are !"#$%&'%()&*+&,(-.*/&'0/("&!*%(1%( considered the most potent inhibitors of acid secretion and permit more rapid healing of DRUG CLASS GENERIC NAME BRAND NAME POSSIBLE ADVERSE the ulcer(s). REACTIONS For patients who have an ulcer without Dexilant abdominal pain evidence of bacterial , physicians will most likely prescribe one of the PPIs Nexium mentioned above. If this class of drugs is elevated liver Proton Pump Prevacid not suitable or does not provide adequate Inhibitors #atulence headache relief, there are alternatives. Another group of (PPIs)* Prilosec drugs that reduces acid production is known Zegerid nausea as H2- antagonists. Cytoprotective Protonix rash agents are sometimes prescribed to protect vomiting the tissues that line the stomach and small Aciphex intestine. Please see the accompanying agitation table for a list of the various agents now confusion available for treating peptic ulcer disease. It Tagamet is extremely important that you follow your Histamine doctor’s instructions on how to take these Pepcid diarrhea medications. You must take them for the Antagonists drowsiness (H2-Blockers)* Axid hallucinations headache Zantac nausea rash vomiting AWARE !"" abdominal pain #A publication of: blackened tongue** Mylan School of Pharmacy constipation contraindicated during Center for Pharmacy Care subsalicylate** Pepto-Bismol Cyto-protective *** Pharmaceutical Information Center (PIC) Agents *** Cytotec diarrhea Additional information on newsletter topics: headache nausea Pharmaceutical Information Center Carafate ringing of the ears 412-396-4600 vomiting [email protected] Questions about screenings or programs: *Many of the drugs in these categories have been reported to interact with prescription and non- prescription drugs. Please check with your doctor or pharmacist before using any of these medications. Christine O’Neil, Pharm.D, B.C.P.S. 412-396-6417 For more information on peptic ulcer disease, please visit the following websites: Newsletter Contributors • www.webmd.com/digestive-disorders/digestive-diseases-peptic-ulcer-disease John G. Lech, Pharm.D. • www.nlm.nih.gov/medlineplus/pepticulcer.html Katie A. Garcia, Pharm.D. • www.mayoclinic.com/health/peptic-ulcer/DS00242 Kevin J. Gillon, Pharm.D. Candidate www.duq.edu/pharmacy Leigh A. Smyczek, Pharm.D. Candidate

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