Practical management of stress-related gastric ulcers

Stress ulcers develop in patients who have been subjected to abnormally elevated levels of stress, especially stress caused by conditions associated with reduced gastric blood flow, such as major burns, hypovolemia, and sepsis. Since a significant, often fatal, upper gastrointestinal hemorrhage is a common sequela of stress ulcers, prevention of progression of the lesions is a sensible goal. In numerous clinical trials, antacids, H2-antagonists, and sucralfate have demonstrated comparable effectiveness in preventing bleeding and the associated life-threatening sequelae. The choice of the ideal agent depends on individual patient factors, concomitant disease states and drug therapy, administration requirements, nursing availability, potential adverse effects, and expense.