Interventions for Peptic Ulcers

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	ANC attendance Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Recognition of symptoms indicative of peptic ulcers including, burning stomach pain, bloating or belching, vomiting, weight loss or poor appetite. Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs Taking fluids Proper nutrition Referral to a health facility
Primary Care
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	ANC attendance Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Guidance on Cessation of tobacco smoking Guidance/advice on Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Guidance on diet Medication to reduce acidity Referral to a hospital
Referral Facility: General
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	ANC Services for the mother Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; ** Blood tests for antibodies due to H.pylori Stool for signs of the bacteria Urea breath test Advice on Cessation of tobacco smoking Advice/guidance on Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding; Perforation, peritonitis.Cancer Management of anemia due to bleeding complication Blood transfusion if ulcers bleeding is severe Follow up
Referral Facility: Specialist
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	ANC Services for the mother Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; Blood tests for antibodies due to H.pylori Stool for signs of the bacteria Urea breath test Advice on Cessation of tobacco smoking Advice/guidance on Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding; Perforation, peritonitis.Cancer Management of anemia due to bleeding complication Blood transfusion if ulcers bleeding is severe Follow up

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease; its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Recognition of symptoms indicative of peptic ulcers including, burning stomach pain, bloating or belching, vomiting, weight loss or poor appetite. Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs Taking fluids Proper nutrition Referral to a health facility
Primary Care
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Guidance on Cessation of tobacco smoking Guidance/advice on Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Guidance on diet Medication to reduce acidity Referral to a hospital
Referral Facility: General
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; Endoscopy X-rays/barium swallow. Blood tests for antibodies due to H.pylori Urea breath test, Stool for signs of the bacteria Biopsy of the stomach Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding, Perforation, peritonitis.Cancer Management of anemia due to bleeding complication Blood transfusion if ulcers bleeding is severe Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers Follow up
Referral Facility: Specialist
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; Endoscopy X-rays/barium swallow. Blood tests for antibodies due to H.pylori Urea breath test, Stool for signs of the bacteria Biopsy of the stomach Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding, Perforation, peritonitis.Cancer Management of anemia due to bleeding complication Blood transfusion if ulcers bleeding is severe Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers Follow up

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Recognition of symptoms indicative of peptic ulcers including, burning stomach pain, bloating or belching, vomiting, weight loss or poor appetite. Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs Taking fluids Proper nutrition Referral to a health facility
Primary Care
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Guidance on Cessation of tobacco smoking Guidance/advice on Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Guidance on diet Medication to reduce acidity Referral to a hospital
Referral Facility: General
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; Endoscopy X-rays/barium swallow Blood tests for antibodies due to H.pylori Urea breath test Stool for signs of the bacteria Biopsy of the stomach Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding; Perforation; peritonitis.Cancer Blood transfusion if ulcers bleeding is severe Management of anemia due to bleeding complication Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers Follow up
Referral Facility: Specialist
Create awareness to the communities/families on peptic ulcer disease including prevention measure Provision of IEC materials on Peptic ulcers disease Community health workers training on peptic ulcers disease, its prevention and remedies at community level	Cessation of smoking Stoppage/avoidance of alcohol to avoid increase in acid in the stomach Stress management Diet control—avoidance of spicy foods Hand hygiene to prevent infections Reduce intake of pain relivers or take medication with meals.		Physical and clinical examination Diagnostic tests including; Endoscopy X-rays/barium swallow Blood tests for antibodies due to H.pylori Urea breath test Stool for signs of the bacteria Biopsy of the stomach Cessation of tobacco smoking Stoppage of alcohol Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs Fluids therapy Combination therapy to eradicate H.Pylori bacteria Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding; Perforation; peritonitis.Cancer Management of anemia due to bleeding complication Blood transfusion if ulcers bleeding is severe Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers Follow up