Which of the following regarding stress ulcers is true?
Stress ulcersStress ulcers are single or multiple mucosal defects which can become complicated by upper gastrointestinal bleeding during the physiologic stress of serious illnessRisk factors Non-critically ill medical patients with 2 or more of the following: respiratory failure, sepsis, hea failure, hepatic encephalopathy, jaundice, renal failure, stroke, hypeension, previous gastrointestinal disease and treatment with coicosteroids, NSAIDS, heparin, or warfarin. In surgical critically ill patients, only those patients who are on a mechanical ventilator for more than 48 hours and/or those with a coagulopathyPathogenesisSite of ulcerationReduction in mucosal blood flow or a breakdown in other normal mucosal defense mechanisms in conjunction with the injurious effects of acid and pepsin on the gastroduodenal mucosaSuperficial ulcers confined to the mucosa and submucosa of stomach and duodenumDiagnosisUpper GI endoscopy TreatmentProphylaxisTreat the cause Hourly antacid administration to maintain intragastric pH above 4 H2 blockersAntacids, H2-receptor blockers, sucralfate, proton pump inhibitors (PPIs), prostaglandin analogs, and nutritionRefer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2203
Cimetidine should be used prophylactically in intensive care patients to prevent stress ulcers
Stress erosions take days to develop and resolve slowly
Surgery is usually the best way to cure stress ulcers
Stress ulcers most often involve the body and fundus of the stomach
All India exam