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Stress ulcer: pathophysiology and prevention

W T Wightkin

    American Journal of Hospital Pharmacy
    |December 1, 1980
    PubMed
    Summary

    Preventing stress ulcers, which are superficial gastric mucosal ulcerations in critically ill patients, is crucial. Antacid titration is the preferred method, though the efficacy of cimetidine remains debated.

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    Area of Science:

    • Gastroenterology
    • Critical Care Medicine

    Background:

    • Stress ulcers are acute, superficial gastric mucosal ulcerations.
    • Critically ill or severely injured patients are at risk.
    • Established stress ulcers have poor treatment outcomes.

    Purpose of the Study:

    • To review the definition, clinical spectrum, risk factors, incidence, pathophysiology, manifestations, diagnosis, and prevention of stress ulcers.
    • To evaluate the effectiveness of various preventive strategies.

    Main Methods:

    • Literature review of stress ulceration.
    • Analysis of risk factors including sepsis, shock, trauma, burns, and major surgery.
    • Evaluation of preventive measures such as antacids, cimetidine, nutritional support, vitamin A, and corticosteroids.

    Main Results:

    • Risk factors for stress ulcers are multifactorial, involving severe illness and injury.
    • Antacid titration is identified as a leading preventive strategy.
    • The preventive role of cimetidine in stress ulceration is considered controversial.

    Conclusions:

    • Prevention of bleeding from stress ulcers is paramount due to limited treatment efficacy.
    • Antacid titration is the recommended approach for stress ulcer prevention.
    • Further research may be needed to clarify the role of agents like cimetidine.

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